Cell Lymphotropic Virus Research Articles

Rapid and Sensitive Qualitative Duoplex Real-Time PCR Method for Discriminatory and Confirmatory Diagnosis of HTLV-1 and HTLV-2 Infections: Brazilian Multicentric Study.

Human T cell lymphotropic virus (HTLV) is the caustive agent of two main conditions i. e., the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and the adult T-cell leukemia/lymphoma (ATLL). HTLV diagnosis is based on serological and molecular approaches; however, an accurate and validated method is still needed. The objective of this study was to establish a rapid and sensitive molecular test to confirm and discriminate HTLV 1/2 types. The test validation was performed as a multicentric study involving HTLV confirmation centers throughout Brazil. Proviral DNA was extracted from whole blood and the amplification was performed using in-house designed primer and probe sets targeting the pol genomic region. An internal control to validate the extraction and amplification was also included. The limit of detection (LoD) of the assay was four copies/reaction for HTLV-1 and 10.9 copies/reaction for HTLV-2. The diagnostic sensitivity of the platform was 94.6% for HTLV-1, 78.6% for HTLV-2, and the specificity was 100% for both viruses. Cross-reactions of the test with human viruses including HAV, HBV, HCV, HIV-1/2, and parvovirus B19 were not observed. During the multicentric validation, the test was used to screen a total of 692 blood samples obtained from previously confirmed HTLV-positive individuals. From these, 91.1% tested positive being concordant with the previously obtained results. In conclusion, our duoplex-RT-PCR-HTLV1 /2 presented adequate efficiency for HTLV-1/2 differentiation showing high sensitivity and specificity. Therefore, it can be a suitable tool for confirmation of suspected and inconclusive HTLV cases, prenatal and pre-transplant diagnosis, in Brazil and in other countries HTLV-endemic countries.

Seroconversion related to Human T-Cell Lymphotropic Virus (HTLV) in a blood bank: a bibliometric study

The first human retrovirus isolated was the Human Cell Lymphotropic Virus (HTLV), belonging to the Retroviridae family, which infects TCD4+/TCD8+ cells. In a blood bank, seroconversion of donors by this virus is investigated by blood surveillance and some studies have shown that, despite the reduction of transfusion-transmitted diseases, the rate of seroconversion has increased. Aim: To define the portfolio of articles on HTLV seroconversion in blood banks. Methodology: This documentary-based study is based on bibliometric methodology, which uses quantitative scientific analysis methods. Data collection for this article was carried out in October and November 2021, in the Web of Science database, a platform that provides a wide range of scientific data for many academic disciplines. Results And Discussions: A low incidence of seroconversion to HTLV, either type 1 or 2, was found in blood banks. The authors described that the seroconversion rate is not high due to the methods used as barriers to transfusion safety, which are the clinical, serological, and immunological screening, methodologies used and standardized in all blood banks. Conclusion: This study allows us to help the scientific community with a documentary portfolio on the subject through mathematical and statistical aspects, the bibliometric indexes.

Impact of Human T Cell Lymphotropic Virus Type 1 and 2 Infection on Survival Following Stem Cell Transplantation

Human T cell lymphotropic virus types 1 and 2 (HTLV-1/2) are delta retroviruses. HTLV-1 may lead to complications, including adult T cell leukemia-lymphoma (ATLL) and HTLV-1-associated myelopathy. Immunosuppression may result in progression from an asymptomatic carrier state to ATLL. Data on the safety of stem cell transplantation (SCT) in patients with HTLV-1/2 infection are lacking. The Center for International Blood and Marrow Transplant Research database was queried for patients who tested positive for HTLV infection in the pretransplantation workup and underwent either autologous SCT (autoSCT) or allogeneic SCT (alloSCT). Patients were excluded if they underwent SCT for ATLL. The primary outcome was overall survival (OS) at 3 years and 4 years post-SCT. In those who underwent autoSCT, 54 patients were HTLV-positive and 9836 were HTLV-negative. In those who underwent alloSCT, 105 patients were HTLV-positive and 18,077 were HTLV-negative. No difference in OS was noted between the HTLV-positive and HTLV-negative patients at 3 years post-autoSCT (76% versus 77%; P=.916). Inferior OS (32% versus 46%; P=.017) and nonrelapse mortality (35% versus 27%; P=.030) were observed in HTLV-positive patients at 4 years post-alloSCT. Future work should examine the mechanism by which HTLV-1/2 impact survival in alloSCT recipients.

Genome analysis suggests HTLV-1aA introduction in Chile related to migrations of ancestral indigenous populations

The human T cell lymphotropic virus type 1 (HTLV-1), unlike other RNA viruses such as HIV, has a stable genome and has infected humans since remote times. Although the HTLV-1 infection is endemic in South America, there is scarce information about HTLV-1 in Chile and its history of introduction. This study assessed the genomic content of HTLV-1 from Chile and its relationship with HTLV-1 lineages circulating worldwide by phylogenetic reconstruction and dating analyses. A total of 30 HTLV-1 genomes collected from the four continents were used to conduct dating analyses, including the first HTLV-1 genome from Amerindian/Mapuche ethnicity. Estimation was performed using a Bayesian Markov Chain Monte Carlo coalescent-based approach as implemented in the BEAST program. The time of the most recent ancestor of HTLV-1 from Chile was ∼1409 years ago, which coincides with the period of Amerindian population expansion across South America. Our results suggest HTLV-1aA was possibly introduced in Chile during the migrations of the ancestral indigenous populations.

Bladder dysfunction in human T cell lymphotropic virus infection: A prospective cohort study.

BackgroundWhile bladder dysfunction is observed in the majority of patients with human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM), it is also observed in patients who do not fulfill all diagnostic criteria for HAM. These patients are classified as having possible or probable HAM/TSP. However, it remains unclear whether the severity and progression of bladder dysfunction occurs similarly between these two groups.ObjectiveCompare the severity and evolution of bladder dysfunction in HTLV-1-infected patients with possible and definite HAM/TSP.MethodsThe present prospective cohort study followed 90 HTLV-1 patients with possible HAM/TSP and 84 with definite HAM/TSP between April 2011 and February 2019. Bladder dysfunction was evaluated by bladder diary, overactive bladder symptoms scores (OABSS) and urodynamic studies. Bladder dysfunction progression was defined as the need for clean self-intermittent catheterization (CIC).ResultsAt baseline, nocturia, urgency and OABSS scores were worse in definite compared to possible HAM/TSP patients. The main urodynamic finding was detrusor overactivity, present in 77.8% of the patients with definite HAM/TSP versus 58.7% of those with possible HAM/TSP (P = 0.05). Upon study conclusion, the cumulative frequency of patients requiring CIC increased in both groups, from 2 to 6 in possible HAM/TSP and from 28 to 44 in definite HAM/TSP patients. The estimated time to need for CIC was 6.7 years (95%CI 6.5–7.0) in the possible HAM/TSP group compared to 5.5 years (95%CI 4.8–6.1) in the definite HAM/TSP group.ConclusionsAlthough both groups showed similarities in bladder dysfunction and tended to progress to requiring CIC over time, patients with possible HAM/TSP presented less severe manifestations at baseline and progressed more slowly than those with definite HAM/TSP.

Response to: RSBMT-2018-0270.R2 - Pain and quality of life in human T cell lymphotropic virus type 1 associated myelopathy or tropical spastic paraparesis after home-based exercise protocol: Randomized clinical trial

Response to: RSBMT-2018-0270.R2 - Pain and quality of life in human T cell lymphotropic virus type 1 associated myelopathy or tropical spastic paraparesis after home-based exercise protocol: Randomized clinical trial

Prevalence of infection by human T Cell lymphotropic viruses (HTLV-1/2) in adult population in Vitória-ES

Introduction: Brazil has a high number of HTLV-1/2 infections which are unequally distributed in the country. Most prevalence studies have focused on specific populations, such as blood donors and pregnant women. Some areas, for example the state of Bahia, have robust information about HTLV-1/2 infection, however there is no information available about this infection in the general population of Vitória, Espírito Santo, Brazil. Objective: To determine the prevalence of HTLV-1/2 infection in adults from the municipality of Vitoria, ES. Methods: A cross sectional study was performed from September 2010 to December 2011, in individuals of both sexes, aged 18 or older living in Vitória-ES. Venous blood samples were collected and tested for anti-HTLV-1/2 antibodies by chemiluminescent immunoassay (CMIA). Individuals with CMIA reactive results were submitted to a new blood collection for retesting by CMIA, followed by PCR to confirm infection and discriminate the viral type. Results: From 1502 tested samples, eight were reactive in CMIA and all were confirmed by PCR. Therefore, the prevalence of HTLV-1/2 was 0.53% (8/1502, 95% CI: 0.2–1.0%). The infection rate was 0.7% in men (5/711, 95% CI: 0.17–1.51%), and 0.38% in women (3/791, 95% CI: 0–0.81%). Conclusions: The prevalence of HTLV-1/2 infection was 0.53% (8/1502; 95% CI: 0.2–0.9%). Confirmatory test using real-time PCR (qPCR) identified seven individuals positive for HTLV-1 and one for HTLV-2. Considering the risk of infected individuals to develop high morbidity and mortality diseases, it would be important to implement public health policies aimed at stopping transmission of these viruses in this municipality.

Sjögren's Syndrome and Viral Infections.

Sjögren’s syndrome (SS) is a systemic autoimmune disease, characterized by lymphocytic infiltration of the secretory glands. This leads to dryness of the main mucosal surfaces such as the mouth, eyes, nose, larynx, pharynx, and vagina. Although there is little morbidity data at the initial diagnosis, SS may be a serious disease, with extra mortality caused by hematological cancer. The cause of SS is unknown, but factors postulated to play a role include genetic and environmental factors, hormonal abnormality, and viral infection. Under the influence of these factors, the immune system becomes abnormal and the tissue is damaged. In this study, we summarize recent developments in our understanding of the relationship between SS and viral infections, including Epstein–Barr virus (EBV), hepatitis C virus (HCV), human T cell lymphotropic virus type 1 (HTLV-1), cytomegalovirus (CMV), and human immunodeficiency virus (HIV).

Evaluation of the Seroprevalence of Infectious Diseases in 2,445 in vitro Fertilization Cycles.

To evaluate the seroprevalence of positive markers for syphilis, human immunodeficiency virus (HIV) I and II, human T cell lymphotropic virus (HTLV) I and II, and hepatitis B and C among women undergoing in vitro fertilization (IVF). We conducted a retrospective analysis among patients who underwent IVF, between January 2013 and February 2016, and who had complete screening records. We analyzed 1,008 patients who underwent IVF, amounting to 2,445 cycles. Two patients (0.2%) tested positive for HIV I and II and none for HTLV I and II. Three patients (0.3%) had positive screening for syphilis, and two (0.2%) had positive hepatitis C antibody test (anti-HCV). A positive hepatitis B virus surface antigen (HbsAg) test was observed in 4 patients (0.4%), while 47 (4.7%) patients were positive for IgG antibody to hepatitis B core antigen (anti-HbC IgG), and only 1 (0.1%) was positive for IgM antibody to hepatitis B core antigen (anti-HbC IgM). The anti-HbS test was negative in 659 patients (65.3%). Only 34.7% of the patients had immunity against the Hepatitis B virus. Patients with an anti-HbS negative result were older than those with a hepatitis B test (anti-HbS) positive result (36.3 versus 34.9; p < 0.001). The present study showed lower infection rates than the Brazilian ones for the diseases studied in patients undergoing IVF. Only a few patients were immunized against hepatitis B.

Frequency of HTLV-1 Antibody in Children of 6 Months to 14 Years old Hospitalized in the Pediatric Ward of Imam Reza Hospital, Mashhad, Iran

Background Human T cell lymphotropic virus type I (HTLV-1) infection is endemic in specific regions of the world, including northeastern Iran. Besides mother to fetus transmission, it can be transmitted through breast feeding, sexual contact, and blood transfusion. The aim of this study was to determine the frequency of HTLV-1 in children. Materials and Methods This cross-sectional study was conducted on children from 6 months to 14 years of age hospitalized in Imam Reza Hospital between January 2016 and January 2017. HTLV-1 antibody testing was done on all patients admitted within one year, and the positive results were further confirmed by Polymerase chain reaction (PCR). After determining the frequency, the types of feeding and possible transmission ways of the virus were investigated. Results Out of the 1358 children admitted, 758 entered the study and were tested for HTLV-1 antibody. The result was positive in 58 patients (7.65%) who were further tested by PCR and 11 (1.45%) had positive antibody result. Out of the 58 positive children, 28 (48.3%) were male and 30 (51.7%) female. Most of the children were in the age range of 6 to 30 months and breastfed. In terms of location, most of them lived in Mashhad (58.62%). Conclusion Our results demonstrated that the frequency of HTLV-1 antibody among children of 6 months to 14 years was 7.65%. They were tested by PCR and 1.45% were positive. This region therefore still remains an endemic area for HTLV-1 infection.

Intrinsic and Extrinsic Cell Apoptotic Pathways in Patients with HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis: A Systematic Review.

We aimed to verify the influence of intrinsic and extrinsic cell apoptotic pathways on the inhibition of cellular apoptosis in patients with tropical spastic paralysis/myelopathy related to human T cell lymphotropic virus type 1. The databases accessed were PubMed, Scopus, Science Direct, and Web of Science. Neither the time of publishing nor the language of the articles was limited. The descriptors used for this systematic literature review were: Tropical Paraparesis, Proto-Oncogenic Protein C, Bcl-2, Bcl-X Protein, Bax protein, Fas ligand (FasL) protein, Fas receptor, TNF-related apoptosis-inducing ligand and Fas-associated protein with death domain (FADD)-like apoptosis regulating. The search resulted in 546 articles from which 9 articles were selected for analysis; ranging from serum levels of Bcl-2, Fas and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) measured by enzyme-linked immunosorbent assay and the levels of cellular expression of Bcl-2 and Bcl-xL the TCD4+ lymphocytes accessed by western blot. Most studies accessed either gene expression or polymorphism of Fas, FasL, and TRAIL in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), whereas one study used flow cytometry and fluorescence to determine Fas expression. Increased Bcl-xL expression inhibited T lymphocyte apoptosis, whereas Bcl-2, serum levels, and cellular expression did not influence T lymphocyte apoptosis and serum levels of Fas were significantly higher and associated with markers of leukocyte activation in patients with HAM/TSP. In addition, Fas polymorphism (FAS-670AA) was associated with higher proviral load. There is a need for additional research on this issue since the number of patients was small and the studies presented higher heterogeneity.

Pain, psychoaffective symptoms, and quality of life in human T cell lymphotropic virus type 1 (HTLV-1): a cross-sectional study.

The objective of this study is to describe the chronic pain characteristics in individuals infected with human T cell lymphotropic virus type 1 (HTLV-1) per subgroup (asymptomatic, oligosymptomatic, and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)) compared with controls with chronic pain without HTLV-1. This is a cross-sectional study investigating associations between pain profile, psychopathological symptoms, and quality of life. Individuals infected with HTLV-1 refer high-intensity pain compared with controls, with more severe characteristics being present in oligosymptomatic and HAM/TSP individuals. Oligosymptomatic individuals have a tendency of diffuse and frequent pain, mainly in the head/neck region and more depressive symptoms, resembling nociplastic pain. Neuropathic pain was localized in the lower limbs in all infected groups, worse in HAM/TSP individuals, and associated with a worse perception of quality of life. Pain was associated to higher levels of TNF-alpha and interferon-gamma. HTLV-1 pain is generally more severe when compared with other chronic pain syndromes, being present mainly in the lower limbs. Certain characteristics are typical, depending on the affected group. Oligosymptomatic and HAM/TSP individuals present more diffuse pain, with higher intensity and greater impact in quality of life. Increased levels of inflammatory cytokines are associated with HTLV-1-related pain.

Non-cytotoxic 1,2,3-triazole tethered fused heterocyclic ring derivatives display Tax protein inhibition and impair HTLV-1 infected cells

Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that infects approximately 10–20 million people worldwide and causes an aggressive neoplasia (adult T-cell leukemia/lymphoma - ATL). Therapeutic approaches for the treatment of ATL have variable effectiveness and poor prognosis, thus requiring strategies to identify novel compounds with activity on infected cells. In this sense, we initially screened a small series of 25 1,2,3-triazole derivatives to discover cell proliferation inhibitors and apoptosis inducers in HTLV-1-infected T-cell line (MT-2) for further assessment of their effect on viral tax activity through inducible-tax reporter cell line (Jurkat LTR-GFP). Eight promising compounds (02, 05, 06, 13, 15, 21, 22 and 25) with activity ≥70% were initially selected, based on a suitable cell-based assay using resazurin reduction method, and evaluated towards cell cycle, apoptosis and Tax/GFP expression analyses through flow cytometry. Compound 02 induced S phase cell cycle arrest and compounds 05, 06, 22 and 25 promoted apoptosis. Remarkably, compounds 22 and 25 also reduced GFP expression in an inducible-tax reporter cell, which suggests an effect on Tax viral protein. More importantly, compounds 02, 22 and 25 were not cytotoxic in human hepatoma cell line (Huh-7). Therefore, the discovery of 3 active and non-cytotoxic compounds against HTLV-1-infected cells can potentially contribute, as an initial promising strategy, to the development process of new drugs against ATL.

Integrative Network Biology Framework Elucidates Molecular Mechanisms of SARS-CoV-2 Pathogenesis.

SummaryCOVID-19 (coronavirus disease 2019) is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the pathophysiology of this virus is complex and largely unknown, we employed a network-biology-fueled approach and integrated transcriptome data pertaining to lung epithelial cells with human interactome to generate Calu-3-specific human-SARS-CoV-2 interactome (CSI). Topological clustering and pathway enrichment analysis show that SARS-CoV-2 targets central nodes of the host-viral network, which participate in core functional pathways. Network centrality analyses discover 33 high-value SARS-CoV-2 targets, which are possibly involved in viral entry, proliferation, and survival to establish infection and facilitate disease progression. Our probabilistic modeling framework elucidates critical regulatory circuitry and molecular events pertinent to COVID-19, particularly the host-modifying responses and cytokine storm. Overall, our network-centric analyses reveal novel molecular components, uncover structural and functional modules, and provide molecular insights into the pathogenicity of SARS-CoV-2 that may help foster effective therapeutic design.

Development of a Unique T Cell Receptor Gene-Transferred Tax-Redirected T Cell Immunotherapy for Adult T Cell Leukemia.

Adult T cell leukemia/lymphoma (ATL) is an aggressive peripheral T cell neoplasm caused by infection with human T cell lymphotropic virus type-1 (HTLV-1). Its prognosis remains extremely poor. Tax, the most important regulatory protein for HTLV-1, is associated with the aggressive proliferation of host cells and is also a major target antigen for CD8+ cytotoxic T cells (CTLs). Based on our previous findings that Tax-specific CTLs with a T cell receptor (TCR) containing a unique amino-acid sequence motif exhibit strong HLA-A*24:02-restricted, Tax301-309-specific activity against HTLV-1, we aimed to develop a Tax-redirected T cell immunotherapy for ATL. TCR-ɑ/β genes were cloned from a previously established CTL clone and transduced into peripheral blood mononuclear cells (PBMCs) of healthy volunteers using a retroviral siTCR vector. Then the cytotoxic efficacy against HTLV-1-infected T cells or primary ATL cells was assessed both in vitro and in vivo. The redirected CTLs (Tax-siCTLs) produced a large amount of cytokines and showed strong killing activity against ATL/HTLV-1-infected T cells in vitro, although they did not have universal activity against ATL cells. Next, in a xenograft mouse model using an HTLV-1-infected T cell line (MT-2), in all mice treated with Tax-siCTLs, the tumor rapidly diminished and finally disappeared without normal tissue damage, although all mice that were untreated or treated with non-gene-modified PBMCs died because of tumor progression. Our findings confirm that Tax-siCTLs can exert strong anti-ATL/HTLV-1 effects without a significant reaction against normal cells and have the potential to be a novel immunotherapy for ATL patients.

High proviral load of human T cell lymphotropic virus type-1 facilitates coronary artery diseases.

Objective(s):Coronary artery disease (CAD) is known as a life threatening disease, worldwide. In this study the role of HTLV-1 infection was evaluated on cardiac involvement in an endemic region of northeastern Iran.Materials and Methods:Serologic and molecular tests for HTLV-1 infection were carried out in subjects who had coronary angiography. A real-time PCR, TaqMan method, to quantify HTLV-1 proviral load (PVL), and routine hematological and biochemical tests were performed for study subjects. Results:Twenty nine patients were HTLV-1+CAD+ and 13 cases were HTLV-1+CAD-. Although, there were no significant differences for risk factors like FBS, HDL, triglyceride, systolic and diastolic blood pressure (Cbp, Dbp), waist circumference (WC), hip circumference (WL), cholesterol (P=0.003), and LDL (P=0.007) levels, and monocyte count (P=0.05) had meaningful differences. The mean HTLV-1 PVL in HTLV-1+CAD+ subjects was 992.62±120 which was higher compared with HTLV-1+CAD- group (406.54±302 copies/104 PBMCs). Moreover, HTLV-1 PVL in males (833±108) was lower compared with females (1218±141 copies/104 PBMCs) (P=0.05). Patients with HTLV-1-PVL of more than 500 copies/104 had more diffused atherosclerosis plaque than patients with less than 500 (OR=6.87, 95% CI=1.34-35.05; P=0.016). Furthermore, patients with diffused coronary atherosclerosis had significantly higher levels of HTLV-1 PVL than patients with middle, proximal, and normal location of coronary sclerotic lesions (P<0.05). Conclusion:Taken together, in endemic area, HTLV-1 infection, more likely is a facilitating factor for heart complications and the high HTLV-1 PVL might affect CAD manifestations.

Molecular detection of human T cell lymphotropic virus type 1 in pregnant women from Maranhão state, Brazil.

The human T cell lymphotropic virus (HTLV) has a worldwide distribution. HTLV is endemic in some states in the northeastern region of Brazil. This study investigated the prevalence of HTLV-1/2 in 713 pregnant women attended at the Central Laboratory of Public Health of Maranhão (LACEN-MA) between February 2015 and May 2017. Serological screening was performed by chemiluminescent microparticle immunoassay (CMIA), and reactive sera were subsequently confirmed by Western blot (WB) analysis. Five samples were determined to be HTLV-1/2-reactive by CMIA analysis, while in the WB analysis, three sera were positive for HTLV-1, and two were indeterminate. The polymerase chain reaction (PCR) analysis used to detect HTLV-1 proviral DNA showed a specific 336 base pair fragment for HTLV-1 in all CMIA-reactive serum samples. PCR products were purified and sequenced. We observed a 0.7% molecular prevalence of HTLV-1 infection. The average age of the HTLV-1-positive pregnant women was 25.6 ± 8.2years, and the average age of the HTLV-1-negative pregnant women was 24.3 ± 6.2 (p= 0.60). We observed that there was no association of HTLV-1 infection with age, ethnicity, marital status, educational level, family income, age of first sexual intercourse, previous pregnancy, breastfeeding, intravenous drug use by partner, history of blood transfusions, or use of condoms. The prevalence of HTLV-1 observed in pregnant women demonstrated the need to implement public health policies for the screening of HTLV-1/2 in prenatal care and counseling to avoid breastfeeding by infected women; this approach could control vertical transmission and reduce the spread of this virus in the population.

Dermatologic Manifestations in HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

Abstract- The human T cell lymphotropic virus type-1 (HTLV-1) is associated with adult T cell leukemia/lymphoma (ATL) and other disorders, including a slowly progressive demyelinating paraparesis, known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Dermatologic manifestations are common in patients infected with HTLV-1 infection. In this study, we evaluated the dermatologic lesions associated with HAM/TSP patients in Mashhad, Iran. Dermatological findings of 37 patients with HAM/TSP were investigated and compared with those of an HTLV-1 negative control group. A cutaneous biopsy was performed as needed, and the results were statistically analyzed. Results of the present study showed that 34 cases with HAM/TSP (91.9%) and 24 cases in the control group (64.9%) had at least one skin lesion or history of skin lesion before (P=0.010). Xerosis was found in 22 persons (59.5%) in the case group and 4 persons in the control group (10.8%) (P=0.000). Only xerosis was significantly associated with HAM/TSP. Skin manifestations were quite frequent in patients with HAM/TSP. Xerosis was significantly associated with HAM/TSP

PF813 PROFILE OF BLOOD DONORS WITH SEROLOGIC TESTS REACTIVE IN HOSPITAL METROPOLITANO IN QUITO‐ ECUADOR FROM JANUARY 2016 TO DECEMBER 2018

Background:A complete infectious disease screening is a transfusion practice that is mandatory. The safest blood donors are from low‐risk populations who donate voluntarily and without compensation. The Ecuadorian government requires blood product screening for Syphilis, Hepatitis B (HBV), Hepatitis C (HBC), immunodeficiency virus (HIV) and Chagas by Roche (Cobas®). Currently, the detection of human T cell lymphotropic virus (HTLV I / II) is excluded due to its low incidence in our country. These tests are carried out by chemiluminescent immunoassay.According to last year's data from the national blood product program (2014), in Ecuador there are approximately 232,137 blood donations per year. The blood bank of the “Hospital Metropolitano” provides approximately 1.4% of the national donations.Aims:To evaluate the demographic characteristics of blood donors with reactive serology in a private hospital in Quito‐Ecuador from January 2016 to December 2018.Methods:This is a descriptive retrospective study. The data was collected from interviews performed prior to the blood donation.A total of 6648 units of blood were collected from voluntaries over the two year period. Donations were made either directly to the hospital's blood bank or through mobile teams. The positive cut off value was calculated as per the manufacturer's directions. Reactive samples were retested before permanent dismissal.Results:During the study period we had 6648 blood donors 26% (1730) were temporary dismissed, and 1.7% (113) were permanently dismissed. The most important reasons for temporary dismissal were high risk sexual behavior (15%) and low hemoglobin (18%). The main motive for permanent dismissal was reactive markers for transfusion transmitted infections (1.3%).Donors with positive serology are mostly men (66%), ranging between ages of 30 to 50 (47%), married (42%) and with high education level (34%). (Table.1) The overall prevalence of HIV reactive tests was 0.17%, 0.06% for HBsAg, 0.36% for Anti‐HCV, 0.35% for Syphilis and 0.41% for Chagas.Summary/Conclusion:The most prevalent reactive marker of transfusion transmitted infections is Chagas. A recent study by Eric Dumonteil et al., reported that Chagas Disease caused by the parasite Trypanosoma cruzi has not been controlled in Ecuador. The most recent estimates from the World Health Organization suggest the presence of nearly 200,000 seropositive patients and a current incidence of 14 per 100,000 per year in Latin America. We found similar reactive serology prevalence of HIV, HBV, HCV and Shyphilis when comparing with worldwide data. The demographic characteristics of donors with reactive serology are also similar when comparing with other available studies. Despite all efforts to guarantee the safety of blood transfusions, transfusion‐transmitted infections remains an important risk. The national blood program of Ecuador is constantly working on improving the selection of blood donors mainly by promoting voluntary donation. In cases of permanent dismissed donors, counseling could improve their willingness to find appropriate medical care.Donor approval or dismissal policies for the prevention of transfusion‐transmitted infections should be based on up‐to‐date information of the local infectious disease epidemiology. Therefore we can conclude that testing for Chagas antibodies remains a priority for blood banks across Ecuador.image

PS1097 ADULT T‐CELL LEUKEMIA/LYMPHOMA: EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOME OF A CARIBBEAN COHORT FROM GUADELOUPE

Background:Adult T‐cell leukemia/lymphoma (ATLL) is a rare mature T‐cell malignancy first described in Japan in 1977. The causative agent of ATLL has been identified as the human T cell lymphotropic virus type 1 (HTLV‐1) which is endemic in Japan, Caribbean area, Central and South America and parts of sub‐Saharan Africa. Whereas Japanese cohorts of ATLL are commonly described, the studies gathering ATLL in the Caribbean islands are less frequently provided. ATLL is an unfrequent and subsequently unknown in Europa in opposite to the French overseas departments of the caribbean area.Aims:To report and describe ATLL in the lesser Antilles at the modern area of zidovudine and interferon treatment.Methods:We identified ATLL patients diagnosed in our institution between 2014 and 2018. Charts were reviewed to report clinicopathologic features, treatment patterns and outcomes of this Caribbean cohort exclusively diagnosed in Guadeloupe (French West Indies). ATLL diagnosis is based for all patients on the presence of a clonal T cells proliferation along with positivity for HTLV‐1 serology.Results:Among 309 patients positive for HTLV‐1 in this period, 24 developed an ATLL (7.76%). The median age at presentation is of 59 years (27–92). The sex ratio M/F was 11/13 (0.84). Based on the Shimoyama classification, 14 patients (58,9%) had acute subtype, 9 (37,5%) had lymphomatous and 1 (4,1%) chronic/smoldering disease. 22/24 had lymphadenopathy or deep tumoral syndrom at diagnosis whereas 2 patients presented splenomegaly. LDH was elevated in 23 patients (mean rate is 4.36N (0.94 – 28.03)). Hypercalcemia was present in half of the cases (mean value of 2,69 mg/dL (1.46 – 4.22)). Lymphocytosis was present in 7 patients (29%) and typical flower cells in 14 cases. Circulating lymphocyte phenotyping, performed for 19 patients, showed clonal T‐cells in 15 cases. Two third of the available karyotype were complex with abnormalities of the chromosome 14 in 50% of the cases.Most of the patients (n = 22, 91.6%) received first‐line treatment, whereas 8.3% (n = 2) quickly passed away before initiating any specific medication. As first line, 11 patients were treated by zidovudine and pegylated interferon +/‐ corticosteroid, 10 patients received a polychimiotherapy only or associated with zidovudine and peg‐interferon and one received corticosteroid only. Among the 15 patients with relapse or refractory diseases, 6 were able to receive a second line treatment. One patient benefits from haploidentical bone marrow transplantation. Five patients are still alive at last follow‐up : 3 patients in complete response (including the transplanted patient), 2 in partial response. Among them, 4 are still treated with interferon and zidovudine. Mean overall survival is 10.1 months (0.2–58.4). Among the 18 death with available data: 10 were related to ATLL progression, 6 related to infections and 2 patients died with acute respiratory distress syndrome.Summary/Conclusion:We report the first description of ATLL in Guadeloupe island. Compared to Japanese cohorts, we have younger patients and dominance of acute and lymphomatous ATLL subtypes. Cytologic detection of flower cells needs trained biologists and Shimoyama classification requires a very low blood cell count (&lt;1%) for lymphomatous category. Nevertheless, this detection can be improved by immunophenotyping which might be worthly introduced in this classification. Despite large and early use of zidovudine and interferon, with or without chemotherapy, ATLL remains a very poor prognostic disease confirming that innovative therapies are still needed.