Human T Cell Lymphotropic Virus Type 1 Viral Load Variability and Long-Term Trends in Asymptomatic Carriers and in Patients with Human T Cell Lymphotropic Virus Type 1-Related Diseases
Human T Cell Lymphotropic Virus Type 1 Viral Load Variability and Long-Term Trends in Asymptomatic Carriers and in Patients with Human T Cell Lymphotropic Virus Type 1-Related Diseases
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DOI：
10.1089/aid.2012.0132
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发表时间：
2013-02-01
影响因子：
1.5
通讯作者：
Taylor, Graham P.
中科院分区：
文献类型：
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作者：
Demontis, Maria A.;Hilburn, Silva;Taylor, Graham P.
成人T细胞白血病/淋巴瘤或HTLV-1相关性脊髓病/热带痉挛性下肢轻瘫（HAM/TSP）患者和一些无症状携带者外周血单个核细胞（PBMC）中的人T细胞嗜淋巴细胞病毒1型（HTLV-1）前病毒载量（PVL）较高，但波动较大。我们的目标是记录更广泛的疾病和组织中HTLV PVL的范围，量化患者内PVL变异性的正常范围，并确定哪些PVL值和变化值得进一步研究。采用实时定量PCR技术，对191例HTLV-1相关疾病患者和211例无症状携带者进行了PVL检测。随着病毒载量降低，试验内变异性增加：高载量时为8%，中等载量时为17%，低载量时为33%。批间变异性与批内变异性无差异。无症状携带者的平均患者内CV为65%（SD 21），HAM/TSP为59%（SD 22）。PVL值在个体之间变化很大，但在个体内相对恒定。脑脊液（CSF）和淋巴结（LN）中的高PVL与疾病相关，但57%的无症状携带者PBMC中的PVL大于1%。我们的研究结果表明：（1）PVL变化超出100%的变异系数需要更详细的评估，（2）PVL高于10%的无症状携带者应接受更频繁的临床和实验室监测，（3）血液和组织中的HTLV-1 PVL有助于HTLV-1感染的诊断和监测。
Human T cell lymphotropic virus type 1 (HTLV-1) proviral load (PVL) in peripheral blood mononuclear cells (PBMCs) is high in patients with adult T cell leukemia/lymphoma or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and in some asymptomatic carriers, but fluctuates. Our objectives were to document ranges of HTLV PVL across a broader spectrum of diseases and tissues, to quantify the normal range of intrapatient PVL variability, and to identify which PVL values and changes deserve further investigation. PVL was measured in 191 patients with HTLV-1-associated diseases and in 211 asymptomatic carriers, using real-time quantitative PCR. The intraassay variability increases as viral load decreases: 8% at high load, 17% at medium load, and 33% at low load. The interassay variability is not different from the intraassay. Mean intrapatient CV is 65% (SD 21) in asymptomatic carriers and 59% (SD 22) in HAM/TSP. PVL values varied widely between individuals, but were relatively constant within individuals. High PVL in cerebrospinal fluid (CSF) and lymph nodes (LN) was associated with disease but 57% of asymptomatic carriers had a PVL greater than 1% in PBMCs. Our results suggest that (1) PVL changes falling outside a coefficient of variation of 100% require more detailed assessment, (2) asymptomatic carriers with PVL higher than 10% should undergo more frequent clinical and laboratory monitoring, and (3) HTLV-1 PVL in blood and tissue is helpful in the diagnosis and monitoring of HTLV-1 infection.