Human T-lymphotropic virus type 1 and type 2 seroprevalence, incidence, and residual transfusion risk among blood donors in Brazil during 2007-2009

• Published in: AIDS research and human retroviruses Vol. 28; no. 10; p. 1265
• Main Authors: Carneiro-Proietti, Anna Bárbara F, Sabino, Ester C, Leão, Silvana, Salles, Nanci A, Loureiro, Paula, Sarr, Moussa, Wright, David, Busch, Michael, Proietti, Fernando A, Murphy, Edward L
• Format: Journal Article
• Language: English
• Published: United States 01.10.2012
• Subjects: Adolescent; Adult; Blood Donors - statistics & numerical data; Brazil - epidemiology; Donor Selection; Female; HTLV-I Antibodies - blood; HTLV-I Infections - blood; HTLV-I Infections - epidemiology; HTLV-I Infections - immunology; HTLV-II Antibodies - blood; HTLV-II Infections - blood; HTLV-II Infections - epidemiology; HTLV-II Infections - immunology; Humans; Immunoenzyme Techniques; Incidence; Male; Mass Screening; Middle Aged; Prevalence; Risk Factors; Sentinel Surveillance; Transfusion Reaction; Young Adult
• ISSN: 1931-8405
• DOI: 10.1089/aid.2011.0143

Human T-lymphotropic virus type 1/2 (HTLV-1/2) infection is endemic in Brazil but representative donor prevalence and incidence data are lacking. All blood donations (2007-2009) from three blood centers in Brazil were studied. Samples reactive on one HTLV screening test (EIA) were retested with a different EIA; dual EIA reactivity correlated strongly with a confirmatory Western blot. Prevalence, incidence, and residual transfusion risk were calculated. Among 281,760 first-time donors, 363 were positive for HTLV on both EIAs (135 per 10(5), 95% CI 122-150). Prevalence differed considerably by region, from 83 to 222 per 10(5). Overall incidence rate was 3.6/10(5) person-years and residual transfusion risk was 5.0/10(6) per blood unit transfused. The logistic regression model showed significant associations with: age [adjusted odds ratio (aOR)=5.23 for age 50+ vs. <20], female sex (aOR=1.97), black (aOR=2.70 vs. white), and mixed skin colors (aOR=1.78 vs. white), and inversely with education (aOR=0.49, college vs. less than high school). HTLV testing with a dual-EIA strategy is feasible and can be useful in areas with low resources. Incidence and residual risk of HTLV-1 transmission by transfusion were relatively high and could be reduced by improving donor recruitment and selection in high prevalence areas. Blood center data may contribute to surveillance for HTLV infection.