Borducchi D M, Oliveira J S, Bordin J O, Kerbauy J
The Hematology and Transfusion Medicine Service-Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Brazil.
Leuk Lymphoma. 1998 Oct;31(3-4):411-6. doi: 10.3109/10428199809059235.
We examined the presence of HTLV-I infection among 66 family members of 13 patients with well documented ATL to investigate the routes of HLTV-I transmission in a Southeast region of Brazil. HTLV-I infection was screened by an enzyme immunossay (ELISA) test and all repeatedly positive or indeterminate ELISA samples were further tested by a Western-Blot (WB) technique. Indeterminate and inconclusive WB samples were confirmed by a polymerase chain reaction (PCR). ELISA results showed that 40 (60.6%) individuals were not infected; 16 (24.2%) were positive; and 10 (15.2%) were undetermined. Among 16 ELISA positive subjects, 14 (87.5%) were confirmed to be positive by WB while 2 (12.5%) showed inconclusive results. Based on the laboratory data, questionnaire analysis, and family/epidemiological studies, we concluded that HTLV-I vertical transmission occurred in 6 of the 13 families. In 3 of these 6 families, the horizontal transmission also could be demonstrated. An isolated horizontal transmission was detected in one family, and in 6 families we did not find any infected family member. All HTLV-I-infected persons were clinically asymptomatic. The occurrence of an effective HTLV-I vertical transmission detected by the present study suggest that HTLV-I infection is endemic in the Southeast region of Brazil. Consistent with the modes of transmission, the HTLV-I antibody seroprevalence was greater in relatives of ATL patients than in the general blood donor Brazilian population (0.4%). In addition, the present data suggest that HTLV-I carries a high infectivity rate but a low virulence.
我们对13例有充分记录的成人T细胞白血病（ATL）患者的66名家庭成员进行了人类嗜T淋巴细胞病毒I型（HTLV-I）感染检测，以调查巴西东南部地区HTLV-I的传播途径。通过酶免疫测定（ELISA）试验对HTLV-I感染进行筛查，所有ELISA检测反复呈阳性或结果不确定的样本均进一步采用蛋白质印迹法（WB）检测。不确定和结果不明确的WB样本通过聚合酶链反应（PCR）进行确认。ELISA结果显示，40人（60.6%）未感染；16人（24.2%）呈阳性；10人（15.2%）结果不确定。在16例ELISA检测呈阳性的受试者中，14例（87.5%）经WB确认为阳性，2例（12.5%）结果不明确。根据实验室数据、问卷调查分析以及家庭/流行病学研究，我们得出结论，13个家庭中有6个家庭发生了HTLV-I垂直传播。在这6个家庭中的3个家庭中，也证实存在水平传播。在1个家庭中检测到孤立的水平传播，在6个家庭中未发现任何感染的家庭成员。所有HTLV-I感染者均无临床症状。本研究检测到有效的HTLV-I垂直传播，这表明HTLV-I感染在巴西东南部地区呈地方性流行。与传播方式一致，ATL患者亲属中HTLV-I抗体血清阳性率高于巴西普通献血人群（0.4%）。此外，目前的数据表明，HTLV-I具有高感染率但低毒力。
