Prevalence of antibodies to HTLV-I/II in blood donors and risk populations in South China

The Impact of Emerging Infectious Diseases on Chinese Blood Safety

Emerging infectious diseases (EIDs) have always been one of the major threats to public health. Although the implementation of mandatory testing for 4 classical transfusion-transmitted infectious-human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis-has reduced the transfusion risk of these pathogens, the potential threat of various EID agents and their constantly evolving variants to blood safety in China is not fully understood. This review presents 9 representative EID agents that are autochthonous and epidemic nationally or regionally in China. The epidemiologic status and distribution of these EID agents among donors and/or healthy populations are summarized. The potential risks of these EID agents to blood safety are discussed. The review also explores strategies to strengthen hemovigilance systems and studies to further evaluate the impact of EID agents on blood safety.

History and update of HTLV infection in China

Human T-lymphotropic virus (HTLV) infection is a high risk factor for lymphoproliferative, inflammatory, and infectious disorders. The epidemiology of HTLV-I, II in industrialized countries has been intensively investigated, and mandatory screening of blood supplies for HTLV-I/II was implemented in mid-1980s in most developed and several developing countries, yet no expanding investigation has been executed in China so far and also been considered as a non-endemic region. However, Gessain et al. reported that the current number of HTLV carriers in the highly populated China is very probably much higher. Therefore, gaining insight into the epidemiology of HTLV infections is essential for avoiding HTLV-induced risk. To introduce the history and renew the HTLV infection in China, we reviewed literatures and conducted an investigation among blood donors in 9 provinces in China. Concluded from the historical and renewed data, the HTLV screen in China can be divided into three stages.

Prevalence of human T-lymphotropic virus type 1 infection among blood donors in mainland China: a meta-analysis

BACKGROUND

Human T-lymphotropic virus type 1 (HTLV-1) is considered to be the etiological agent of adult T-cell leukemia/lymphoma (ATL) and HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Blood transfusion is a common transmission pathway for HTLV-1. However, no surveys to determine the overall prevalence of HTLV-1 infection and HTLV-1 genotypes among blood donors on the Chinese mainland have yet been conducted.

METHODS

A systematic review and meta-analysis of the peer-reviewed literature on this topic was carried out. Data manipulation and statistical analyses were performed using the Comprehensive Meta Analysis Version 2.0 program.

RESULTS

Forty-four eligible articles involving 458525 blood donors were selected. Analysis revealed the pooled prevalences of HTLV-1 infection among blood donors in Fujian and Guangdong provinces to be 9.9/10000 (95% confidence interval (CI) 4.4/10000-22.2/10000) and 2.9/10000 (95% CI 1.7/10000-4.8/10000), respectively; there were only two cases of HTLV-1 infection among 204763 donors in other areas of the Chinese mainland. In addition, 40 of 42 (95.2%) HTLV-1 isolates belonged to the Transcontinental subgroup A of the HTLV-1 subtype A (Cosmopolitan subtype).

CONCLUSIONS

The prevalence of HTLV-1 infection among blood donors is low and restricted mainly to the provinces of Fujian and Guangdong. Most isolates belong to the Transcontinental subgroup within HTLV-1 subtype A.