厦门市无偿献血者HTLV感染情况及基因亚型分析

HTLV infection and HTLV genetic typing among voluntary blood donors in Xiamen,China

目的了解人类T淋巴细胞白血病病毒(HTLV)在厦门市无偿献血人群中的感染情况及基因亚型的特点。方法采用ELSIA方法自2004年2月起对来厦门市中心血站献血的全部献血者131 823人做抗-HTLV-1/2筛检,对ELISA检测阳性的标本经巢式PCR、Taqman MGB探针及WB法检测确认并确定HTLV亚型。结果在5年1个月的时间里,ELISA法初筛抗-HTLV阳性58例;经巢式PCR或Taqman MGB探针检测确认为HTLV-1阳性的标本24例,阳性率为0.02%(24/131 823)。分析其中16例阳性标本的gp46序列发现其都属于HTLV-1A亚型,其中15株序列属于世界人种亚群,另外1株属于日本人种亚群。结论厦门市无偿献血者中存在HTLV感染且感染者均为HTLV-1型,以世界人种亚群为主,并有少量的日本人种亚群;对献血者的HTLV筛查可有效杜绝经输血传播HTLV,进一步提高输血安全。

Objective To assess the prevalence of HTLV infection and its subtypes in Xiamen,China. Methods Blood samples were obtained from voluntary blood donors （ n = 131 823 ） from the Xiamen Blood Center from February, 1,2004, to March 31,2009. Initial screening for HTLV-1/2 antibody was performed using the anti-HTLV （1 ＋ 2） antibody ELISA kit.Positive samples identified by ELISA were confirmed by Western Blotting （WB） and/or real-time fluorescence PCR （Taqman- MGB probe）. Results 24（0.02% ,24/131 823）cases were identified as positive for HTLV-1. The gp46 sequences of 16 HTLV-positive specimens were analyzed. Comparison of these sequences with the gp46 sequences of representative strains belonging to different subtypes from GenBank revealed that all the sequences belonged to the HTLV-I A subtype （Cosmopolitan）, 15 strains belonged to the Transcontinental Subtype, and 1 strain belonged to the Japanese Subtype. Conclusion HTLV virus-infected individuals occur in Xiamen blood donors and mainly concentrated in the southeast coastal areas. To prevent HTLV transmission via blood transfusions and to improve blood safety,it is necessary to detect the virus in a timely manner in areas with high incidence and central cities with high population mobility. More systematic studies need to be performed on the molecular epidemiology of HTLV in Xiamen and surrounding areas to further clarify the distribution of the HTLV subtypes ,to further explore the relationship between the for- eign and domestic sources of virus strains, and to determine the origin, transmission route, and mechanism of evolution of HTLV.