Line immunoassay for confirmation and discrimination of human T-cell lymphotropic virus infections in inconclusive western blot serum samples from Brazil

KR Campos, FLN Santos, V da Silva Brito… - Journal of Clinical …, 2019 - Am Soc Microbiol
KR Campos, FLN Santos, V da Silva Brito, NLS Gonçalves, THA Araujo, B Galvão-Castro
Journal of Clinical Microbiology, 2019Am Soc Microbiol
Difficulties in confirming and discriminating human T-cell lymphotropic virus type 1 (HTLV-1)
and HTLV-2 infections by serological Western blot (WB) assays (HTLV Blot 2.4; MP
Biomedicals) have been reported in Brazil, mainly in HIV/AIDS patients, with a large number
of WB-indeterminate and WB-positive but HTLV-untypeable results. Nonetheless, a line
immunoassay (LIA)(INNO-LIA HTLV-I/II; Fujirebio) provided enhanced specificity and
sensitivity for confirming HTLV-1/2 infections. To add information concerning the improved …
Abstract
Difficulties in confirming and discriminating human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infections by serological Western blot (WB) assays (HTLV Blot 2.4; MP Biomedicals) have been reported in Brazil, mainly in HIV/AIDS patients, with a large number of WB-indeterminate and WB-positive but HTLV-untypeable results. Nonetheless, a line immunoassay (LIA) (INNO-LIA HTLV-I/II; Fujirebio) provided enhanced specificity and sensitivity for confirming HTLV-1/2 infections. To add information concerning the improved ability of the LIA in relation to WB when applied to samples of individuals from different risk groups from Brazil, we performed the present study. Three groups were analyzed: group 1 (G1), with 62 samples from HIV/AIDS patients from São Paulo, SP (48 WB indeterminate and 14 HTLV untypeable); group 2 (G2), with 24 samples from patients with hepatitis B or hepatitis C from São Paulo (21 WB indeterminate and 3 HTLV untypeable; 17 HIV seropositive); and group 3 (G3), with 25 samples from an HTLV outpatient clinic in Salvador, Bahia (16 WB indeterminate and 9 HTLV untypeable; all HIV seronegative). Overall, the LIA confirmed HTLV-1/2 infection (HTLV-1, HTLV-2, or HTLV) in 66.1% (G1), 83.3% (G2), and 76.0% (G3) of samples. Interestingly, the majority of WB-indeterminate results were confirmed by the LIA as being HTLV-2 positive in G1 and G2 but not in G3, in which the samples were defined as being HTLV-1 or HTLV positive. These results agree with the virus types that circulate in such patients of different regions in Brazil and emphasize that the LIA is the best serological test for confirming HTLV-1 and HTLV-2 infections, independently of being applied in HTLV-monoinfected or HTLV-coinfected individuals.
American Society for Microbiology