The Prevalence of Human T-Lymphotropic Virus Infection among Blood Donors in Southeast China, 2004-2013
The Prevalence of Human T-Lymphotropic Virus Infection among Blood Donors in Southeast China, 2004-2013
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DOI：
10.1371/journal.pntd.0003685
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发表时间：
2015-04-01
影响因子：
3.8
通讯作者：
Chen, Changrong
中科院分区：
文献类型：
--
作者：
Xie, Jinzhen;Ge, Shengxiang;Chen, Changrong
背景人类嗜T淋巴细胞病毒1型（HTLV-1）与成人T细胞白血病/淋巴瘤、HTLV-1相关脊髓病/热带痉挛性下肢轻瘫（HAM/TSP）和HTLV相关葡萄膜炎等疾病相关，可引起输血传播感染。虽然在发达国家已经对献血者进行了常规的HTLV筛查，但是对于不进行HTLV筛查的发展中国家献血者中HTLV的流行情况知之甚少，例如中国。在2004-2013年期间。采用酶联免疫吸附试验（ELISA）对献血者进行HTLV-1/2的筛查，并经免疫印迹试验和核酸检测进行确证。计算不同城市献血员中HTLV-1的感染率。结果在253,855名献血员中，43人血清学检测为HTLV-1阳性（16.9/10万，95%CI：12.3-22.8），未发现HTLV-2感染。来自福建省城市的献血者（24.3/100，000，95%CI：17.4-33.1）的HTLV-1血清阳性率显著高于（p=0.001）出生在非福建省城市的献血者（3.4/100，000，95%CI：0.7-9.8）。在福建省9个城市中，宁德市献血员的患病率最高（171.3/10万，95%CI：91.3-292.8）。对27例HTLV-1携带者的病毒序列进行分子鉴定，发现25例为A基因型的横贯大陆亚型，2例为A基因型的日本亚型。有趣的是，25个横贯大陆亚型序列中有12个在病毒gp 46蛋白中具有特征性的L55 P突变，该突变仅存在于来自日本和台湾的横贯大陆亚型序列中，而不存在于来自其他国家的序列中。福建省HTLV-1流行率较高，可能与宁德市的地方性疫源地有关。
BackgroundThe human T-lymphotropic virus type 1 (HTLV-1) which is associated with the diseases of adult T-cell leukemia/lymphoma, HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and HTLV-associated uveitis, can cause transfusion-transmitted infections. Although HTLV screening of blood donors was already routinely performed in developed countries, little is know about the HTLV prevalence among blood donors in developing countries which do not perform HTLV screening, such as China.Objectives & AimsTo systematically characterize the prevalence of HTLV infection among bloods in southeast China.MethodsA 10-year survey for HTLV prevalence in blood donors was performed in Xiamen, southeast China, during 2004-2013. The HTLV-1/2 of blood donations were screened by enzyme-linked immunosorbent assay, following with confirmation by western blot assay and 9nucleic acid testing. The HTLV-1 prevalences in donors from different cities were calculated. Viral sequences derived from identified HTLV-positive cases were sequenced and analyzed.ResultsAmong 253,855 blood donors, 43 were confirmed to be seropositive for HTLV-1 (16.9 per 100,000 95% CI: 12.3-22.8) and none HTLV-2 infection was found. The HTLV-1 prevalence varied significantly in donors from different cities. Donors from cities in Fujian province (24.3 per 100,000, 95% CI: 17.4-33.1) had a significantly higher (p=0.001) HTLV-1 seroprevalence than those who were born in non-Fujian cities (3.4 per 100,000, 95% CI: 0.7-9.8). Among nine cities in Fujian province, the highest prevalence was found in blood donors from Ningde (171.3 per 100,000, 95% CI: 91.3-292.8) which is a coastal city in the northeast of Fujian. Molecular characterization of viral sequences from 27 HTLV-1 carriers revealed 25 were Transcontinental subtype of genotype A and 2 were Japanese subtype of genotype A. Interestingly, 12 of 25 Transcontinental subtype sequences harbored a characteristic L55P mutation in viral gp46 protein, which was only presented in the Transcontinental subtype sequences from Japan and Taiwan but not in that from other countries.ConclusionsAlthough China is considered to be a non-endemic region for HTLV, the HTLV-1 prevalence in blood donors is significantly higher in Fujian province, southeast China. A higher prevalence of HTLV-1 in the Fujian may be attributed to endemic foci in the city of Ningde.