RESUMO
Mother-to-child transmission of human T-cell lymphotrophic virus type 1 (HTLV-I) is primarily due to prolonged breast-feeding (>6 months) in the post-natal period. Most infant infections are not identifiable until 12-18 months of age by available whole virus Western blot serologic tests because of their inability to distinguish passively transferred maternal antibody from infant antibody. We investigated two methods to assess more accurately the time of infant infection. In prospectively collected serial biospecimens, HTLV-I-specific immunoglobulin (Ig) isotypes of IgM and IgA were determined by Western blot and HTLV-I proviral DNA was detected by polymerase chain reaction (PCR). IgA and IgG reactivity was assessed in periodic serum samples from 16 HTLV-I-seropositive children while IgM reactivity was observed in 100 percent of children at 24 months of age and 73 percent of children at 6-12 months of age; however, this could represent maternal and not infant antibody. Both IgA and IgM reactivity were insensitive indicators of infection, with only 50 percent of children showing reactivity at 24 months of age. PCR testing was performed in biospecimens obtained from 11 of these children. An estimated median time of infection of 11.9 months was determined by PCR, which was similar to the median time to infection determined by whole virus Western blot (12.4 months; P=0.72). PCR Tests support a median time to infection that is similar to that estimated by whole virus Western blot. (AU)
Assuntos
Adulto , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Lactente , Aleitamento Materno , Transmissão Vertical de Doenças Infecciosas , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Infecções por HTLV-I/transmissão , DNA Viral/análise , Estudo de Avaliação , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/virologia , Anticorpos Anti-HTLV-I/sangue , Imunoglobulina A/sangue , Imunoglobulina M , Jamaica , Reação em Cadeia da Polimerase/métodos , Estudos Prospectivos , Provírus , Fatores de TempoAssuntos
Adulto , Humanos , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Leucemia de Células T/virologia , Linfoma de Células T/virologia , Biomarcadores , Leucemia de Células T/patologia , Leucemia de Células T/fisiopatologia , Linfoma de Células T/patologia , Linfoma de Células T/fisiopatologia , Prognóstico , Biomarcadores TumoraisRESUMO
Human papillomavirus (HPV) is widely accepted as the primary etiologic agent in the development of cervical cancer. DNA of a particular HPV type, HPV 16, is found in about half of tumors tested. Inconsistent with this causal relationship, however, population-based studies of HPV DNA prevalence have often failed to find high rates of anogenital HPV infection in countries with high cervical cancer rates. To examine this issue, we used serology to compare HPV 16 exposure in healthy volunteer blood donors in the United States (n = 278) and similar subjects from a country with 3-fold higher cervical cancer rates, Jamaica (n = 257). Jamaican sexually transmitted disease (STD) patients (n = 831) were also studied to examine in detail the relation of HPV 16 antibodies with sexual history. Serology was conducted using an ELISA employing HPV 16 virus-like particles (VLPs). Age-adjusted seroprevalence rates were greatest among male (29 percent) and female (42 percent) STD patients, intermediate in male (19 percent) and female (24 percent) Jamaican blood donors and lowest among male (3 percent) and female (12 percent) U.S. blood donors. The higher seroprevalence in women was significant, and prevalence tended to increase with age. In multivariate logistic regression, controlling for age and gender, Jamaican blood donors were 4.2-fold (95 percent CI 2.4 - 7.2) and STD patients 8.1-fold (95 percent CI 5.0 - 13.2) more likely to have HPV 16 VLP antibodies than U.S. blood donors. Among STD patients, HPV 16 antibodies were associated with lifetime number of sex partners and years of sexual activity, as well as other factors. Our data suggest that HPV 16 VLP antibodies are strongly associated with sexual behavior. Moreover, exposure to HPV 16 appears to be much greater in Jamaica than in the United States, consistent with the high rate of cervical cancer in Jamaica (Au)
Assuntos
Adulto , Idoso , Adolescente , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudo Comparativo , Anticorpos Antivirais/sangue , Doadores de Sangue/estatística & dados numéricos , Neoplasias do Colo do Útero/virologia , Proteínas Oncogênicas Virais/imunologia , Papillomavirus Humano/imunologia , Fatores Etários , Análise de Variância , Jamaica/epidemiologia , /epidemiologia , /imunologia , Fatores de Risco , Comportamento Sexual , Fatores Sexuais , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/imunologia , Infecções Tumorais por Vírus/epidemiologia , Infecções Tumorais por Vírus/imunologia , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero , Proteínas Oncogênicas Virais/sangueRESUMO
From a cohort of human T-cell lymphotropic virus type I (HTLV-I) exposed transfusion recipients (N=71) enrolled in the Jamaican Transfusion Study, 11 were selected for detailed laboratory evaluation. All recipients were followed at monthly intervals for 6 months and then bimonthly up to 1 year for evidence of HTLV-I seroconversion. Without regard to results on screening assays, pretransfusion and posttransfusion samples were tested with two licensed HTLV-I whole-virus screening enzyme immunoassays (EIAs), recombinant EIAs for antibody against tax (p40x) and p21e envelope, standard whole virus Western blot (WB), WB enhanced with recombinant p21e, and radioimmunoprecipitation assay (RIPA). In the early period post transfusion, antibody to gag core protein was predominant with anti-p24 generally appearing before anti-p19. Recombinant anti-p21e envelope protein, in EIA and WB format, was frequently the earliest envelope reactively detected, while anti-gp46 in WB and anti-gp61/68 in RIPA system appeared later. Anti-tax antibodies appeared later in the time course of seroconersion. The whole-virus EIAs were less sensitive than the confirmatory assays. The combination of WB and RIPA or WB enhanced with recombinant p21e appeared equally effective in confirming samples as positive by the Public Health Service two gene group confirmatory algorithm. However specificity of this assay approach could not be addressed in this study.(AU)
Assuntos
Humanos , Adolescente , Adulto , Idoso , Masculino , Feminino , Transfusão de Sangue , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/transmissão , Idoso de 80 Anos ou mais , Antígenos Virais/imunologia , Western Blotting , Produtos do Gene env/imunologia , Produtos do Gene gag/imunologia , Produtos do Gene tat/imunologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Infecções por HTLV-I/imunologia , Técnicas Imunoenzimáticas , Jamaica , Proteínas Recombinantes/imunologia , Proteínas do Envelope Viral/imunologiaRESUMO
Human T-lymphotropic virus type I (HTLV-I), the prototype human retrovirus, has been linked epidemilogically to adult T-cell leukemia-lymphoma and to tropical spastic paraparesis. Modes of infection include mother-to-child transmission, most likely by ingestion of breast milk; parenteral transmission by blood transfusion and intravenous drug abuse; and male-to-female sexual transmission. Female-to-male transmission of HTLV-I is thought to occur only rarely, if at all. We document risk factors for male-to-female and female-to-male transmission of HTLV-I among persons in Jamaica attending clinics for sexually transmitted disease.(AU)
Assuntos
Humanos , Adolescente , Adulto , Masculino , Feminino , Infecções Sexualmente Transmissíveis/epidemiologia , Soropositividade para HIV/epidemiologia , HIV-1 , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/transmissão , Jamaica , Doenças do Pênis/complicações , Sífilis/complicações , Western Blotting , Ensaio de Imunoadsorção Enzimática , Estudos Transversais , Análise de Regressão , Fatores de Risco , Testes Sorológicos , Comportamento SexualRESUMO
Detection of human T lymphotropic virus type I (HTLV-I) antibody was assessed on 368 sera from subjects with different clinical features and from different parts of the world. Enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay for purified p24 antibodies (p24-RIA) used as screening tests agreed in 88.7 percent of the sera. The results from 247 selected sera were compared with western blot (WB). WB was reactive in sera five to 25 times more dilute than the last positive ELISA or p24-RIA, but different WB batches varied in sensitivity. ELISA was more sensitive than p24-RIA, and p24-RIA was more specific than ELISA. Indeterminate WB interpretations were common (25.5 percent). Most seropositive intravenous drug abusers had unusually strong p24 bands by WB. Among healthy individuals, positive WB reactivity increased with age, whereas indeterminate reactivity declined (P=.034). Thus more sensitive and -specific HTLV-I antibody tests are needed. (AU)