Infection with human T lymphotropic virus type I in organ transplant donors and recipients in Spain†
Members of the HTLV Spanish Study Group: C. Tuset, G. Marcaida, and T. Tuset (Hospital General Universitario, Valencia); E. Caballero (Hospital Vall d'Hebron, Barcelona); A. Aguilera, E. Prieto, and B. Regueiro (Hospital Xeral, Santiago de Compostela); R. Ortiz de Lejarazu and J. M. Eirós (Hospital Clínico Universitario, Valladolid); R. Benito (Hospital Clínico Universitario Lozano Blesa, Zaragoza); J. García (Hospital Cristal-Piñor, Orense); J. del Romero and C. Rodríguez (Centro Sanitario Sandoval, Madrid); E. Calderón, A. Vallejo, F. J. Medrano, and M. Leal (Hospital Virgen del Rocío, Seville); F. Capote (Hospital Puerta del Mar, Cadiz); G. Cilla and E. Pérez-Trallero (Hospital Nuestra Señora de Aránzazu, San Sebastián); F. Dronda (Hospital Ramón y Cajal, Madrid); E. Pujol (Hospital Juan Ramón Jiménez, Huelva); P. Álvarez and Marta García-Campello (Complejo Hospitalario, Pontevedra); M. Rodríguez-Iglesias (Hospital Universitario de Puerto Real, Cadiz); E. Franco (Centro de Transfusión de la Comunidad Valenciana, Valencia); M. Adelantado and A. Castro (Centro de Transfusiones de Galicia, Santiago); A. M. Martín y O. Evora (Hospital Insular, Las Palmas de Gran Canaria); A. Guelar (Hospital del Mar, Barcelona); T. Pumarola and J. M. Miró (Hospital Clínic, Barcelona); C. Toro, B. Rodés, S. Bassani, J. González-Lahoz, and V. Soriano (Hospital Carlos III, Madrid).
Abstract
Human T-cell lymphotropic virus (HTLV) antibody screening is not recommended uniformly before transplantation in Western countries. In the year 2001, the first cases of HTLV-I infection acquired through organ transplantation from one asymptomatic carrier were reported in Europe. All three organ recipients developed a subacute myelopathy shortly after transplantation. This report rose the question about whether to implement universal anti-HTLV screening of all organ donors or selective screening of donors from endemic areas for HTLV-I infection should be carried out. A national survey was conducted thereafter in which anti-HTLV antibodies were tested in 1,298 organ transplant donors and 493 potential recipients. None was seropositive for HTLV-I and only one recipient, a former intravenous (i.v.) drug user, was found to be infected with HTLV-II. In a different survey, HTLV screening was conducted in 1,079 immigrants and 5 (0.5%) were found to be asymptomatic HTLV-I carriers. All came from endemic areas for HTLV-I infection. No cases of HTLV-II infection were found among immigrants. These results support the current policy of mandatory testing of anti-HTLV antibodies in Spain only among organ transplant donors coming from HTLV-I endemic areas or with a highly suspicion of HTLV-I infection. J. Med. Virol. 76:268–270, 2005. © 2005 Wiley-Liss, Inc.
