Keywords
human T-cell lymphotopic virus type 2 (HTLV-2)
diagnosis
serology
enzyme immunoassay (EIA)
Western blot (WB)
polymerase chain reaction (PCR)
How to Cite
Abstract
Taking into account the problems on the human T-cell lymphotropic virus type 1 and 2 (HTLV-1 andHTLV-2) laboratory diagnosis in samples analyzed at Instituto Adolfo Lutz, São Paulo, it was proposed anew algorithm employing two blood samples serially collected. The first serum sample was for serological screening using two enzyme immunoassays (EIAs), and the second blood sample collected on EDTA was for retesting EIAs and to confirm HTLV-1/2 infection by Western blot (WB) and polymerase chain reaction (PCR). The results obtained on 313 blood samples showed inefficiency of this algorithm as only 25% of EIAs positive samples had a second blood sample collected, and of which the blood were correctly collected on EDTA from three patients only. No feasible data were achieved to compare the actual performance of PCR in relation to WB. Thus, we started to use a simple algorithm (one step) for diagnosing HTLV-1/2 ona single blood sample collected on EDTA for screening and confirmatory assays.References
1. Ministério da Saúde. HTLV-I/II - Triagem e diagnóstico sorológico em Unidades hemoterápicas e laboratórios de saúde pública. Brasília: Ministério da Saúde, Coordenação Nacional de Doenças Sexualmente Transmissíveis e Aids. 1998. II (Série TELELAB); 54p.
2. Jacob F, Santos-Fortuna E, Azevedo RS, Caterino-de-Araujo A. Performances of HTLV serological tests in diagnosing HTLV infection in high-risk population of Sao Paulo, Brazil. Rev Inst Med trop Sao Paulo. 2007; 49: 361-4.
3. Jacob F, Santos-Fortuna E, Azevedo RS, Caterino-de-Araujo A. Serological patterns and temporal trends of HTLV-1/2 infection in high-risk populations attending Public Health Units in São Paulo, Brazil. J Clin Virol. 2008; 42: 149-55.
4. Jacob F, Santos-Fortuna E, Caterino-de-Araujo A. Algorítmo de testes sorológicos de triagem para infecção por HTLV-1/2 usado no Instituto Adolfo Lutz de São Paulo. BEPA - Boletim Epidemiológico Paulista. 2008; 5: 12-8.
5. Jacob F, Magri MC, Costa EAS, Santos-Fortuna E, Caterino-de Araujo A. Comparison of signal-to-cutoff values in first, second, and third generation enzyme immunoassays for the diagnosis of HTLV-1/2 infection in “at-risk” individuals from São Paulo, Brazil. J Virol Methods. 2009; 159: 288–90.
6. Caterino-de-Araujo A. Best screening assays for the diagnosis of human T-cell lymphotropic virus types 1 and 2 in South America. J Virol Methods. 2009;156: 150-1.
7. Mahieux R, Horal P, Mauclère P, Mercereau-Puijalon O, Guillotte M, Meertens L, Murphy E, Gessain A. Human T-cell lymphotropic virus type 1 gag indeterminate Western blot patterns in Central Africa: relationship to Plasmodium falciparum infection. J Clin Microbiol. 2000; 38: 4049-57.
8. Berini CA, Eirin ME, Pando MA, Biglione MM. HumanT-cell lymphotropic virus types I and II (HTLV-I and II) infection among seroindeterminate cases in Argentina. J Med Virol. 2007; 79: 69-73.
9. Morimoto HK, Morimoto AA, Reiche EMV, Ueda LT, Matsuo T, Reiche FV, Caterino-de-Araujo A. Difficulties in the diagnosis of HTLV-2 infection in HIV/AIDS patients from Brazil: Comparative performances of serologic and molecular assays, and detection of HTLV-2b subtype. Rev Inst Med trop S Paulo. 2007; 49(4): 225-30.
10. Mangano AM, Remesar M, del Pozo A, Sen L. Human T lymphotropic virus types I and II proviral sequences in Argentinian blood donors with indeterminate Western blot patterns. J Med Virol. 2004; 74: 323-7.
11. Jacob F. Levantamento do perfi l sorológico de infecção pelos vírus linfotrópicos de células T humanas dos tipos 1 e 2 (HTLV-1 e HTLV-2) em casuística encaminhada ao Instituto Adolfo Lutz de São Paulo para análise. [Dissertação de Mestrado] São Paulo (SP): Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde, 2007. 103 pp.
12. Ministério da Saúde. Portaria nº 34, de jul. 2005. Diário Ofi cial da União, Brasília, 29 de jul. 2005. Procedimentos seqüenciados para realização do diagnóstico da infecção pelo HIV utilizando-se testes rápidos em indivíduos com idade acima de 18 (dezoito) meses. [Regulamenta o uso de testes rápidos para diagnóstico da infecção pelo HIV em situações especiais].
13. Costa JMP, Segurado AC. Molecular evidence of human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) infections in HTLV seroindeterminate individuals from São Paulo, Brazil. J Clin Virol. 2009; 44: 185–9.
14. Gallego S, Mangano A, Gastaldello R, Sen L, Medeot S. Usefulness of a Nested-Polymerase Chain Reaction for Molecular Diagnosis of Human T-cell Lymphotropic Virus Type I/II. Mem Inst Oswaldo Cruz. 2004; 99(4): 377-80.
15. Gudo ES, Abreu CM, Mussá T, Augusto AR, Otsuki K, Chambo E, Amade N, Tanuri A, Ferreira OC, Jani IL. Serologic and molecular typing of human T-lymphotropic virus among blood donors in Maputo city, Mozambique. Transfusion. 2008; 49(6): 1146-50.
16. Casseb J, Penalva-de-Oliveira AC. The pathogenesis of tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy. Braz J Med Biol Res. 2000; 33: 1395-401.
17. Casseb J, Fukumori LMI, Vergara MPP, Sanabani S, Marchiori PE, Duarte AJS, Penalva-de-Oliveira AC. Lack of tax diversity for tropical spastic paraparesis/human T-cell lymphotropic virus type 1 (HTLV-I) associated myelopathy development in HTLV-I-infected subjects in São Paulo, Brazil. Mem Inst Oswaldo Cruz. 2006; 101(3): 273-6.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2009 Instituto Adolfo Lutz Journal