Confirming the presence of HTLV-1 infection and the absence of HTLV-2 in blood donors from Arequipa, Peru

Abstract

SuMMarYEpidemiological studies conducted in Peru disclosed HTLV-1 to be prevalent in different ethnic groups, and found HTLV-2 in some Amazonian Indians and in men who have sex with men. No data concerning HTLV-1/2 infection in blood donors from Arequipa, a highlands region in southern Peru, is available. We searched for the presence of HTLV-1 and HTLV-2 antibodies in 2,732 serum samples obtained from blood donors from this geographic area. HTLV-1/2-specific antibodies were detected using an enzyme-linked immunosorbent assay (ELISA) and were confirmed by Western blot (WB). Reactive sera had their blood bags discarded from donation, and the demographic characteristics of the donors were analyzed. Thirty-five sera (1.2%) were HTLV seroreactive by ELISA, and 25 were confirmed HTLV-1-positive by WB. One serum disclosed HTLV-positivity, and the remaining nine serum samples showed indeterminate results by WB; three of which had an HTLV-1 indeterminate Gag profile. The median age of HTLV-positive individuals was 34.6 years; 27 were male and eight were female. All individuals were from southern Peru: 27 from Arequipa, five from Puno, and three from Cuzco. HTLV co-positivity with hepatitis B (five sera) and syphilis (one serum) were detected. Previous transfusion and tattooing were observed in two and one individuals, respectively. No serum was positive for HTLV/HIV co-infection. This study confirmed, for the first time, HTLV-1 infection and the absence of HTLV-2 infection in blood donors from Arequipa, Peru and suggests vertical transmission as the major route of HTLV-1 transmission and acquisition in this geographic region.

Epidemiological Aspects and World Distribution of HTLV-1 Infection

“…In Peru, a real multiethnic country mainly inhabited by Mestizos and Amerindians, HTLV-1 prevalence in blood donors ranges from 1.2 to 1.7% depending on the region (Quispe et al, 2009) and from 1.3 to 3.8% in pregnant women or in the adult general population (Zurita et al, 1997; Sanchez-Palacios et al, 2003; Alarcon et al, 2006). Furthermore several large series of TSP/HAM and ATL have been reported (Gotuzzo et al, 2004; Beltran et al, 2011).…”

Dermatomiositis y síndrome de Evans asociado a infección por HTLV-1

“…En Latinoamérica, las tasas de seropositividad para HTLV-1 entre donantes de sangre alcanza 0,1 a 2%. En el Perú, desde Junio de 1998 el Ministerio de Salud ha dispuesto el despistaje de HTLV-1 obligatorio en los bancos de sangre entre los donantes de sangre con lo cual se evitan aproximadamente 4000 transfusiones infectadas por año (2,25,26) Por lo tanto, es poco probable que en nuestra paciente, la transmisión del virus se haya producido por esta vía, y más bien creemos que la procedencia de la paciente de una zona de alta endemicidad para el HTLV-1 como es Ayacucho con patrones culturales que alientan la lactancia materna prolongada hayan sido determinantes para la infección viral.…”

Transmisión vertical de HTLV-1 en el Perú

“…De acuerdo con estos autores, el Perú es un área endémica de HTLV-1, dado que la prevalencia entre donantes de sangre, gestantes, trabajadoras sexuales, homosexuales varones y varones privados de libertad en varias partes del país se encuentra entre 1 a 7% (5–16,17) .…”

“…En todos los estudios publicados (5,–13,17,18) , excepto dos (16,17) , la prevalencia encontrada ha sido mayor al 1%. Uno de ellos, realizado en 370 pobladores quechuas voluntarios residentes en Cusco y Quillabamba, encontró una prevalencia total del 5,1%; en este estudio la prevalencia en gestantes sanas es de 2,3% (5 de 211 gestantes) (5) .…”

“…Otro, en 568 mujeres sanas de más de 20 años en tres regiones del Perú, encontró una prevalencia general del 2,5%, correspondiendo 1,3% a Huanta (Ayacucho) 3,8% a El Carmen (Ica) y 3,8% a Lima. (9) Los dos estudios en que la prevalencia fue menor de 1% fueron realizados en donantes de sangre de Arequipa (0,9%) (16) y de Puente Piedra, distrito periférico de Lima (0,75%) (17) .…”