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The objectives of this study were to estimate the prevalence and characterize the epidemiologic patterns of HTLV-1/2 infections and co-infections with HIV, HBV (hepatitis B), HCV (hepatitis C), and Treponema Pallidum in five different high-risk groups, including injecting drug users (IDUs), female sex workers (FSWs), men who have sex with men (MSM), patients with tuberculosis (TB), and patients attending clinics for sexually transmitted infections (STIs) in Buenos Aires, Argentina. The HTLV-1/2 prevalence was 19.1% (33/173) for IDUs, 2.0% (10/613) for FSWs, 2.1% (4/187) for TB, 1.0% (4/400) for STIs and 0.4% (3/282) for MSM, respectively. Among all groups, the higher percentages of co-infection were HTLV-1/HBV (63%, 17/27) and HTLV-1/HCV (52%, 14/27). Among IDUs, there was a high percentage of co-infection of HTLV-2 with HCV (96.3%, 26/27), HIV (92.6%, 25/27), and HBV (77.8%, 21/27), respectively. In summary, HTLV-1/2 infections appear to be widely distributed among high-risk groups in a nonendemic area of Argentina being the co-infection with HBV and HCV more frequent among IDUs.

In Argentina, current procedures to ensure the safety of the blood supply for transfusion include the serologic detection of specific blood-borne infections. The aim of this study was to evaluate the prevalence and the genetic diversity of hepatitis B virus (HBV) and hepatitis D virus (HDV) in blood donor populations from two distantly located Argentine regions. Data from 56,983 blood donations from the Favaloro Foundation, in the city of Buenos Aires (Central Region), and the Central Blood Bank of Misiones Province (Northeast Region) were analyzed. Samples that were reactive for HBsAg were analyzed for HBV-DNA characterization and HDV serological and molecular analysis. The HBV prevalence was 0.12 % for HBsAg and 1.68 % for anti-HBc antibodies in Buenos Aires, and 0.73 % and 8.55 %, respectively, in Misiones. Seventy-seven HBsAg-reactive samples were analyzed by polymerase chain reaction for HBV-DNA. Subgenotypes A2, B2, C2, F1b and F4 (Buenos Aires) and F1b and D3 (Misiones) were detected. Several mutations within the major hydrophilic region of HBsAg, the reverse transcriptase, the basal core promoter, and the precore/core were detected. HDV genotype 1 was identified in Buenos Aires. This study confirms the circulation of several HBV subgenotypes, as well as known and newly identified variants, and the presence of HDV1 in this population. A thorough investigation has to be carried out to evaluate the clinical importance of some of the documented mutations as well as those detected in the HDV1 case.

Infection with HIV, HBV, and T pallidum was elevated among MSM. Routine testing, education, vaccine-based prevention, and control programs need to be implemented in this high-risk population.

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Human T-cell lymphotropic virus (HTLV) seroindeterminate cases have been reported among blood donors (BD) and in at-risk populations worldwide, including Argentina. The objective of the present work was to study the presence of HTLV-I/II infection and its association to specific Western blot (WB) patterns among healthy BD and at-risk populations in Argentina. We analyzed 83 HTLV-I/II seroindeterminate WB cases diagnosed among BD (n = 49) and in different at-risk populations (n = 34) for human retroviruses infections. Multiple indeterminate WB patterns were observed. Out of the total, 13.2% (11/83) of the cases were found to be HTLV-I/II positive by nested-PCR (n-PCR), including 13.2% (11/83) HTLV-I and 2.4% (2/83) presenting HTLV-I and -II co-infection. Most of their serological profiles showed reactivity to gag or env codified proteins. Two samples amplified only one of the six analyzed genes (1 HTLV-I pol gene and 1 HTLV-II tax gene). There was no association between the presence of Trypanosoma cruzi infection and an HTLV-I/II indeterminate WB pattern (only 3 of the 83 samples were positive for T. cruzi antibodies). In conclusion, the majority of HTLV-seroindeterminate WB donors lacked HTLV provirus and was thus considered uninfected. However, when seroreactivity to Env and Gag proteins are observed on the WB and especially in at-risk populations, HTLV infection should be suspected; such individuals should be followed-up and retested.

In Argentina, current procedures to ensure safety of the blood supply for transfusion include reviewing the records of blood donors with particular attention to the serologic detection of specific blood borne infections. Data of 28,483 blood donations received from January 1, 2003 to December 31, 2008 in a public hospital in Buenos Aires were analyzed. Of the 28,483 blood donations, 7,442 (26.1%) were female donors, 14,582 (51.2%) were younger than 35 years old, and 23,746 (83.4%) were Argentine. Among all, only 285 (1.0%) were voluntary donations. The prevalence of HTLV-1/2 was 0.1% (95% CI 0.063-0.15), being 0.07% for HTLV-1 and 0.03% for HTLV-2. The prevalence of HIV-1 was 0.2% (95% CI 0.110-0.206). No HIV-1/HTLV-1/2 co-infections were detected among volunteer donors. During this study period, data confirm that HTLV-1/2 infection was not endemic in Buenos Aires, and that the prevalence of HTLV-1/2 decreased throughout while HIV-1 was stable. Due to the small number of voluntary donations, we could not conduct comparisons to infection rates in replacement donations. Although there have been several ongoing programs aimed at recruiting voluntary blood donations and changing from mostly replacement donations to an altruistic system of blood donations, Argentina is still far from reaching this objective. Additional efforts are needed in order to increase and assure the quality of blood supply in this country.

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