Abstract
To systematically characterize the prevalence and evolution of human T-cell lymphotropic virus (HTLV) infection among voluntary blood donors (BDs) in Guangdong province, China. A three-year survey for HTLV epidemiology among BDs was performed in Guangdong during 2016-2018. Anti-HTLV-1/2 was screened by ELISA and ECLIA, and subsequently confirmed by western blot (WB) and nucleic acid testing (NAT). The prevalence of HTLV in donors from different cities was calculated. The identified HTLV-positive cases were phylogenetically genotyped and analyzed in a Bayesian phylogenetic framework. Among 3,262,271 BDs, 59 were confirmed positive for HTLV-1 (1.81 per 100,000) and no HTLV-2 infection was found. The prevalence of HTLV-1 varied significantly among 21 cities in Guangdong province, China. The highest prevalence was found in donors from Shanwei (13.94 per 100,000), which is a coastal city in eastern Guangdong. Viral genomic sequences genotyped from 55 HTLV-1 carriers showed that 39 were transcontinental subtype and 16 were Japanese subtype. Specially, 13 out of 39 transcontinental subtype sequences were characterized with L55P mutation and 21 out of 55 sequences were characterized with L19F mutation in viral gp46 protein. The L55P mutation seemed be specific to eastern Asia since it only presented in the sequences from Japan, mainland China, and Taiwan. Phylogenetic analysis of gp46 gene shows that HTLV-1a may have been introduced to Guangdong through four different introduction events and formed major transmission clusters: clades I(13,602 years ago), II(16, 010 years ago), III(15,639 years ago) and IV(16,517 years ago). In general, Guangdong is considered to be a low-prevalence region for HTLV-1 infection, but the prevalence is significantly higher in Shanwei city. Transcontinental and Japanese subtype lineages dominate the prevalence in Guangdong. In terms of blood safety, HTLV antibody screening for first-time blood donors can effectively reduce the risk of HTLV transmission.
Highlights
The World Health Organization (WHO) published an open letter in May 2018 calling for global efforts to eradicate human T-cell lymphotropic virus type 1(HTLV-1) infection [1], which causes cancer and several other diseases such as adult T-cell leukemia/lymphoma and HTLV-1 associated myelopathy/tropical spastic parparesis
We performed a 3-year large-scale blood screening survey to systematically characterize the prevalence of HTLV infection among blood donors in Guangdong province in south China during 2016–2018
Guangdong was considered to be a low-prevalence region for HTLV-1 infection, but the prevalence is significantly higher in Shanwei, a coastal city of eastern Guangdong
Summary
The World Health Organization (WHO) published an open letter in May 2018 calling for global efforts to eradicate human T-cell lymphotropic virus type 1(HTLV-1) infection [1], which causes cancer and several other diseases such as adult T-cell leukemia/lymphoma and HTLV-1 associated myelopathy/tropical spastic parparesis. The HTLV-1 infected population is up to 10 to 15 million [2]. HTLV-1 is mainly prevalent in the Caribbean, South and Central America, Central and Western Africa, Southwestern Japan, Australia and Melanesia[4]. HTLV-2 is relatively common among intravenous drug users and their sex partners in Europe, North America, and other regions of the world [5]. Since 1988, serological screening has been included in routine blood screening in certain developed countries and regions such as American countries and some parts of Western Europe and East Asia [6]. Except for Iran and Japan, epidemiological data regarding HTLV infection seems to be rare in most Asian countries. We aimed to investigate the prevalence of HTLV among BDs in Guangdong province, which has the largest resident population and immigrant population of more than 100 million in China
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