Seroprevalence of human T-lymphotropic virus infection among blood donors in China: a first nationwide survey

Le Chang,Zhengang Shan,Fei Guo,Shanhai Ou,Ying Yan,Huimin Ji,Lunan Wang,Xinyi Jiang,Faming Zhu,Huizhen Sun,Xia Rong

doi:10.1186/s12977-020-00546-w

Abstract

BackgroundSo far, the prevalence of human T-lymphotropic virus (HTLV) type 1 and 2 in some highly populated countries such as China is still unknown. In this study, a multi-center nationwide serological survey was designed and performed, to reveal the seroprevalence of HTLV infection among Chinese blood donors.ResultsAmong 8,411,469 blood donors from 155 blood establishments, 435 were finally confirmed as HTLV carriers. The prevalence of HTLV infection in China varied in different provinces: Fujian had the highest prevalence of 36.240/100,000 (95% CI 31.990–41.050) and eleven provinces did not find HTLV-seropositive donors in the three years. no HTLV-2 infection was found. The overall prevalence of HTLV-1 in China decreased from 2016 to 2018. Female was identified as an independent risk factor of HTLV infection in China. Besides, seroconversion was observed in two of seven seroindeterminate donors 85 and 250 days after their last donation, respectively.ConclusionsThe seroprevalence of HTLV infection in most areas of China among blood donors is quite low, but it varies significantly in different geographic areas. Screening anti-HTLV-1/2 antibody and follow-up of serointederminate donors are essential to ensure blood safety especially in areas where we have found HTLV infected donors.

Highlights

The prevalence of human T-lymphotropic virus (HTLV) type 1 and 2 in some highly populated countries such as China is still unknown
In Fujian, Guangdong, and Zhejiang province, 4,497,616 blood donors were tested, among which 2629 were repeatedly reactive by screening tests and 370 donors were confirmed as Human T-lymphotropic virus type 1 (HTLV-1) infection by a confirmatory test
Laboratories (NCCL) for further testing and 104 samples weren’t tested because of lack of volume or other reasons. 63.9% (988/1546) samples were non-reactive by all four different supplementary assays, while 558 samples were reactive by at least one assay and tested by line immunoassay. 63 samples were positive by the confirmatory test, among which 49 donors were discriminated as HTLV-1 infection and 14 were untypeable

Summary

Introduction

The prevalence of human T-lymphotropic virus (HTLV) type 1 and 2 in some highly populated countries such as China is still unknown. A multi-center nationwide serological survey was designed and performed, to reveal the seroprevalence of HTLV infection among Chinese blood donors. HTLV-1 shows a unique endemic distribution in the world, with high endemic rates of infection in southwestern Japan, the Caribbean islands, Central and South. Data from some highly populated countries and regions such as China were not available. Since HTLV was found as a member of the transfusion-transmitted infectious pathogen [7], blood donor screening for anti-HTLV antibody was first introduced in Japan in 1986. Two years later commercial HTLV-1 antibody assay became available in the United States [8], followed by other countries. The Creative Commons Public Domain Dedication waiver

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