A Systematic Review for Estimation of HTLV-I Infection in the Blood Donors of Iran.

Abstract

HTLV-I infection is a worldwide health problem and approximately 15–20 million persons are estimated to be infected with this infection (1). High HTLV-I seroprevalence rates in the general population or specific groups such as blood donors, have been reported from southwest of Japan, Caribbean basin, South America, Sub-Saharan Africa, and northeastern Iran (1,2). Although most infected people remain asymptomatic, the virus is associated with exceptionally severe diseases, such as adult T-cell leukemia/lymphoma (ATL), and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) (3). HTLV-I infection could transmit from mother to child, predominantly through breastfeeding, via sexual intercourse, and parenteral transmission by transfusion of infected cellular blood products or sharing of needles and syringes (1,4). Presence of HTLV-I infection was reported in 1990 among the Jews emigrated from Mashhad, northeast of Iran (5), and then some patients with ATL were indentified in Mashhad who were seropositive for HTLV-I (6). In later studies, the rate of HTLV-I infection in Mashhad was reported 3% in general population (7) and about 2% in blood donors (8) in 1996. There were some small to large scale epidemiological studies that have reported the prevalence of HTLV-I infection in blood donors from various regions of the country. The widest survey has been conducted by Rezvan et al. in 21 regional blood centres in 1996. This study reported a 0.29% rate for HTLV-I infection in total serum samples; 1.97% among Mashhadi blood donors, and zero to 0.5 percent in other centres (8). Moreover, later surveys in several regions of Iran reported different rates of the infection in blood donors. Nevertheless, there is no overall estimation of the infection in the country. This study conducted to accurately estimate the prevalence of HTLV-I infection in the Iranian blood donors through a comprehensive systematic review of literature and evidences.