Comparative performances of an HTLV‐I/II EIA and other serologic and PCR assays on samples from persons at risk for HTLV‐II infection

Poiesz, Bernard J.; Dube, Syamalima; Choi, David; Esteban, Eduardo; Ferrer, Jorge F.; Leon‐Ponte, Matilde; Pérez, G.; Glaser, Jordan B.; Devare, S G; Vallari, Ana; Schochetman, Gerald

doi:10.1046/j.1537-2995.2000.40080924.x

Cited by 23 publications

(23 citation statements)

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“…These results contrast with prior reports of a relatively high rate of false-negative HTLV-1/2 EIA results in HIV-positive as well as HIV-negative populations (11,12). However, our data are in agreement with more recent reports in which no cases of "occult" HTLV-1/2 infections have been found in HTLV-1/2 EIAnonreactive individuals (3,4,7).…”

supporting

confidence: 94%

“…Although we could not test HTLV-1/2 PCR in immunocompetent subjects with indeterminate HTLV WB results, results obtained in the immunosuppressed group are consistent with previous reports that have shown that PCR for HTLV-1/2 is the most sensitive and specific assay (7). Taken together, HTLV-1/2 PCR is strongly recommended for HIV-infected patients with indeterminate HTLV WB results.…”

supporting

confidence: 88%

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Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

Bassani¹,

Toro²,

Jiménez³

et al. 2006

Clin Vaccine Immunol

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nosuppression, whereas PCR should be performed for subjects with a reactive HTLV EIA which is not further confirmed by WB.As with other retroviruses, the diagnosis of human T-cell lymphotropic virus type 1 (HTLV-1) or type 2 infections is generally made using serological assays that assess the presence of specific HTLV-1/2 antibodies. The recommended algorithm advises to first perform a screening enzyme immunoassay (EIA) to detect both viruses followed by Western blot (WB) testing of reactive samples to confirm infection and discriminate between HTLV-1 and HTLV-2. This approach is often accompanied by a high proportion of indeterminate WB results when low-risk populations, such as blood donors (1, 10), are tested, although subsequent PCR analyses discharge the presence of HTLV-1/2 infection in almost all cases. In contrast, in high-risk populations, such as intravenous drug users (IDU), indeterminate HTLV WB patterns or even nonreactive EIA results may be seen in persons with true HTLV-2 infection (6, 11). Since IDU are often coinfected with human immunodeficiency virus type 1 (HIV-1), it has been suggested that immunosuppression could explain the inability to mount and/or maintain an appropriate level of HTLV-2 antibodies, particularly in advanced stages of HIV disease (6). A similar poor antibody response has been described for hepatitis C virus in HIV-positive individuals, causing "occult" infections (2). Herein, we assess the impact of HIV-related immunosuppression on the performance of current serological tests used for HTLV-2 diagnosis.A large group of former IDU known to be HIV positive and on regular follow-up at our institution was analyzed. We have previously reported a high prevalence of HLTV-2 infection in this population (8). A total of 175 IDU had severe immunosuppression, with a CD4 cell count below 200 cells/l. They were matched by age, gender, and place of residence with 175 HIV-positive IDU with a preserved immune status and CD4 cell counts above 500 cells/l. Serum specimens were tested for antibodies to HTLV-1/2 using a commercial EIA (Murex HTLV IϩII; Abbott, Barcelona, Spain). Samples with repeated EIA reactivity were tested using a commercial WB (Bioblot HTLV; Genelabs, Singapore). These WB strips contain HTLV-1 viral lysate and three recombinant envelope proteins: the transmembranous HTLV gp21 (rgp21), the surface gp46 from HTLV-2 (rgp46-II), and the surface gp46 from HTLV-1 (rgp46-I). The HTLV European Research Network criteria (5) were used for interpreting WB patterns. Briefly, HTLV-2 positivity was considered when reactivity to at least two recombinant envelope bands (rgp21 and rgp46-II) and the gag band p24 was seen. HTLV-2 infection was considered negative when no bands appeared in the WB. Other WB patterns were interpreted as HTLV indeterminate.A specific HTLV-1/2 PCR was performed in all subjects with CD4 counts below 200 cells/l, as previously described elsewhere (9). Briefly, the HTLV-1/2 PCR was performed using nested primers (12P1, SK111, 12P5, 1P1, and 2P3) directed against th...

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supporting

confidence: 94%

supporting

confidence: 88%

Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

Bassani¹,

Toro²,

Jiménez³

et al. 2006

Clin Vaccine Immunol

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show abstract

“…The development of new EIA kits for HTLV that use recombinant proteins and synthetic peptides has increased the sensitivity and specificity of such kits, in comparison with kits that use viral lysate [25][26][27] . In contrast, the WB test for HTLV-1/2 has shown little development over recent years, and is unsuitable for blood banks because of its high costs and high proportion of indeterminate results [28][29][30][31][32] . This situation suggests that there is a need to confirm virus infection by means of molecular tests.…”

Section: Discussion Ethics Committee Approval This Study Was Approvedmentioning

confidence: 99%

“…The results indicated that WB failed to detect infection by HTLV type 2, and this was also observed in two other cases that were not included in this study. Previous studies have shown that the confirmatory sensitivity of WB for HTLV-2 is worse than for HTLV-1 and presents a greater frequency of indeterminate or false negative results [28][29][30][31] . Two (5%) out of the 40 WB-positive samples from blood donors did not present reactivity in the WB test for either of the recombinant proteins (rgp46-I or rgp46-II).…”

Section: Discussion Ethics Committee Approval This Study Was Approvedmentioning

confidence: 99%

Evaluation of the use of real-time PCR for human T cell lymphotropic virus 1 and 2 as a confirmatory test in screening for blood donors

Andrade¹,

Ribeiro²,

Namen-Lopes³

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: HTLV-1/2 screening among blood donors commonly utilizes an enzymelinked immunosorbent assay (EIA), followed by a confirmatory method such as Western blot (WB) if the EIA is positive. However, this algorithm yields a high rate of inconclusive results, and is expensive. Methods: Two qualitative real-time PCR assays were developed to detect HTLV-1 and 2, and a total of 318 samples were tested (152 blood donors, 108 asymptomatic carriers, 26 HAM/TSP patients and 30 seronegative individuals). Results: The sensitivity and specificity of PCR in comparison with WB results were 99.4% and 98.5%, respectively. PCR tests were more efficient for identifying the virus type, detecting HTLV-2 infection and defining inconclusive cases. Conclusions: Because real-time PCR is sensitive and practical and costs much less than WB, this technique can be used as a confirmatory test for HTLV in blood banks, as a replacement for WB.

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“…However, because of the sensitivity of the assay, strict adherence to control procedures is necessary to avoid cross-contamination. The development of PCR procedures for HTLV-1 and HTLV-2 has allowed investigations to determine the prevalence and potential disease associations of HTLV-2 (1,8,26,27). In addition, PCR can be used to directly diagnose individuals with HTLV-2 infection without the need for virus isolation.…”

Section: Polymerase Chain Reaction For Detection For Htlv-2 From Cellmentioning

confidence: 99%

Isolation and Confirmation of Human T-Cell Leukemia Virus Type 2 From Peripheral Blood Mononuclear Cells

Lairmore

Montgomery

Human Retrovirus Protocols

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Comparative performances of an HTLV‐I/II EIA and other serologic and PCR assays on samples from persons at risk for HTLV‐II infection

Abstract: There were no significant differences among the sensitivities and specificities of the HTLV-I/II ELISAs (p values, 0.056-0.438). The WB and PCR assays were much more specific than the other serologic assays (p

Cited by 23 publications

References 61 publications

Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

Can the Level of Immunosuppression in Human Immunodeficiency Virus-Infected Patients Affect the Reliability of Human T-Cell Lymphotropic Virus Type 2 Serological Diagnosis?

Evaluation of the use of real-time PCR for human T cell lymphotropic virus 1 and 2 as a confirmatory test in screening for blood donors

Isolation and Confirmation of Human T-Cell Leukemia Virus Type 2 From Peripheral Blood Mononuclear Cells

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