Detection of Rare Cases of HTLV-I and -II Infections and High Numbers of HTLV-Seroindeterminate Results in Bavarian Blood Donors

Abstract

Background: In order to evaluate the prevalence of human T-cell lymphotropic virus type I and II (HTLV-I/-II) infections in Germany, the Bavarian blood donor population was screened. Material and Methods:Between 1991 and 1994 around 1.5 million donations from about 375,000 blood donors of the Bavarian Red Cross (BRK) were tested for HTLV-I/-II in an antibody screening test. Sera repeatedly reactive in the screening test at the BRK blood bank were further assayed in additional enzyme-linked immunosorbent assays (ELISA), Western blot (WB) and radioimmunoprecipitation assay (RIPA). Selected donors were analyzed by polymerase chain reaction (PCR). Results:Only 4 HTLV-I/-II infections could be confirmed by WB and by RIPA, indicating a seroprevalence of 0.001%. Three positive donors were American soldiers and the fourth one was a German woman. Out of 609 sera reactive in at least two antibody screening tests, only 4 could be confirmed in WB as HTLV-I or -II positive. However, reactivity of these sera appears not to be related to an HTLV-I or -II infection, as shown by selected samples testing negative by RIPA and PCR. Conclusions:HTLV-I/-II seroprevalence in Bavarian blood donors is very low which implies that a general testing of all blood donations should not be recommended. However, donors with sexual partners from HTLV-endemic regions should be tested. Concerning serological diagnosis, we would suggest to modify the WHO-based interpretation criteria in countries with low HTLV prevalences: Only sera with antibodies to 1 or 2 Gag andthe 2 recombinant Env proteins should be considered HTLV positive.

Clinical Features and Treatment Outcomes of Vitiligo from the Patients’ Perspective: Results of a National Survey in Germany

“…The first point may be offset by the fact that the sample is larger than all studies published to date. Questioning patients concerning clinical features has been found to be effective by convergent testing, with body schema and with quality of life [24,26,27], for example. Another frequent selection bias which cannot be ruled out in this study is the fact that the data can only be obtained from those patients who are motivated to answer.…”

Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

“…The self-administered Psoriasis Area and Severity Index (SAPASI) is a patient-rated instrument with adequate psychometric properties to assess the objective clinical severity of psoria sis [38,39,40,41,42]. To be applicable in the Internet setting, the SAPASI was slightly modified (mSAPASI): as in the original version, patients rated the intensity of erythema, induration and scaliness on a 12-cm visual analogue scale (VAS) [40].…”

Defective human T‐cell leukaemia virus type 1 (HTLV‐1) genomes: No evidence in serologically indeterminate german blood donors but new type detected in established cell lines

“…ELISA-reactive samples are further investigated by Western blotting. Serum samples that fail to pass the criteria for seropositivity (reactivity against one Gag-and two Env-coded proteins) are considered as indeterminate [Goubau et al, 1996;Fleischer et al, 1999]. In countries with low HTLV-1 prevalence, indeterminate results are a major problem in virus diagnostics Fleischer et al, 1999].…”

“…Serum samples that fail to pass the criteria for seropositivity (reactivity against one Gag-and two Env-coded proteins) are considered as indeterminate [Goubau et al, 1996;Fleischer et al, 1999]. In countries with low HTLV-1 prevalence, indeterminate results are a major problem in virus diagnostics Fleischer et al, 1999]. These cases are generally re-examined using HTLV-1/-2-PCR with 2±3 gene-speci®c (diagnostic) sets of primers [Lal et al, 1992] or generic PCR primers .…”

“…These sera reacted in Western blot at least with p19 matrix protein (MA) and rgp21 (ENV), but were negative in PCR (pol and tax) [Fleischer et al, 1999]; the reaction with these two HTLV antigens was considered as a hint to the presence of at least part of the viral genome expressing viral antigens, but which is incapable to replicate or produce infectious virus. As a control, samples from HIV-negative haemophilia patients who received uninactivated clotting factor preparations were used.…”