Human T cell lymphotropic virus type 1 infection among U.S. thalassemia patients.
Human T cell lymphotropic virus type 1 infection among U.S. thalassemia patients.
复制标题
美国地中海贫血患者中人类 T 细胞淋巴细胞病毒 1 型感染。
DOI：
10.1089/aid.2012.0382
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发表时间：
2013
影响因子：
1.5
通讯作者：
Heneine,Walid
中科院分区：
文献类型：
--
作者：
Switzer,WilliamM;Shankar,Anupama;Trimble,SeanR;Thompson,AlexisA;Giardina,PatriciaJ;Cohen,AlanR;Coates,ThomasD;Vichinsky,Elliott;Neufeld,EllisJ;Boudreaux,JeanneM;Heneine,Walid
地中海贫血是一种遗传性遗传疾病，需要多次输血来治疗由低血红蛋白水平引起的贫血。因此，地中海贫血患者面临感染血源性病原体的风险，包括通过输血细胞血液制品传播的人类T细胞嗜淋巴细胞病毒（HTLV）。在这里，我们检查了234名美国人中HTLV的患病率。地中海贫血患者使用2008年收集的血清。使用酶免疫测定法（EIA）和区分HTLV-1和HTLV-2的确证性蛋白质印迹法（WB）检测血清中的HTLV-1/2抗体。在研究入组时收集人口统计学信息和临床信息，包括HIV和丙型肝炎病毒（HCV）状态。3例患者（1.3%）WB阳性; 2例为HTLV-1，1例无法血清分型为HTLV-1/2。所有3名HTLV阳性者均为HIV-1阴性，1名为HCV血清阳性。该人群HTLV阳性率高于HIV-1（0.85%），低于HCV（18.8%）。所有三名患者（年龄26-46岁）在出生后不久被诊断为β-地中海贫血，此后每年接受多次输血。在1988年实施HTLV血液筛查之前，两名HTLV阳性患者确认接受了输血。我们发现，在美国地中海贫血患者中，HTLV-1血清阳性率显著高于献血者。我们的研究结果强调了对地中海贫血和其他需要多次输血的疾病患者进行HTLV检测的重要性，特别是在未经筛查的输血接受者中。此外，对HTLV感染患者进行适当的咨询和随访是必要的。
Thalassemia is an inherited genetic disorder requiring multiple transfusions to treat anemia caused by low hemoglobin levels. Thus, thalassemia patients are at risk for infection with blood-borne pathogens, including human T cell lymphotropic viruses (HTLV) that are transmitted by transfusion of cellular blood products. Here, we examined the prevalence of HTLV among 234 U.S. thalassemia patients using sera collected in 2008. Sera were tested for antibodies to HTLV-1/2 using enzyme immunoassay (EIA) and a confirmatory western blot (WB) that differentiates between HTLV-1 and HTLV-2. Demographic information and clinical information were collected at study enrollment, including HIV and hepatitis C virus (HCV) status. Three patients (1.3%) were WB positive; two were HTLV-1 and one could not be serotyped as HTLV-1/2. All three HTLV-positive persons were HIV-1 negative and one was HCV seropositive. The HTLV seroprevalence was higher than that of HIV-1 (0.85%) and lower than HCV (18.8%) in this population. All three patients (ages 26–46 years) were diagnosed with β-thalassemia shortly after birth and have since been receiving multiple transfusions annually. Two of the HTLV-positive patients confirmed receiving transfusions before HTLV blood screening was implemented in 1988. We identified a substantial HTLV-1 seroprevalence in U.S. thalassemia patients that is much greater than that seen in blood donors. Our findings highlight the importance of HTLV testing of patients with thalassemia and other diseases requiring multiple transfusions, especially in recipients of unscreened transfusions. In addition, appropriate counseling and follow-up of HTLV-infected patients are warranted.