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ID naloge: 8 Letnik: 1997 Predmet: mikrobiologija in imunologija
Razširjenost okužbe s humanim T-celicnim limfotropnim virusom tipa I (HTLV-I) v Sloveniji
Avtor: Jurij Bednarik, Katarina Rednak
Mentor: doc. dr. Mario Poljak, dr. med.
Somentor: asist.dr. Katja Seme, dr. med.
IZHODIŠCA. Cloveški T-celicni limfotropni virus tipa I oz. HTLV-I (okr. angl. human T-cell lymphotropic virus type I) uvršcamo v družino Retrovirusov, poddružino Onkovirusov.Prenaša se s spolnimi odnosi, z okuženo krvjo, z matere na otroka preko posteljice in zdojenjem. Virus HTLV-I povzroca pri približno 1% okuženih T-celicno levkemijo ter posebnoobliko mielopatije. V nekaterih državah kri krvodajalcev rutinsko testirajo na prisotnostprotiteles proti virusu HTLV-I. V Sloveniji se krvi krvodajalcev ne testira. To utemeljujejo zvec dejstvi: zelo majhen delež okuženih zboli; pri presejalnih testih je veliko lažno pozitivnih rezultatov; prekuženost z virusom HTLV-I je v Sloveniji domnevno nizka, karsicer ni bilo nikoli dokazano. V naši raziskavi, ki je prva tovrstna v Sloveniji, smoželeli ugotoviti prekuženost z virusom HTLV-I v naši državi. Posebej smo želeliugotoviti prekuženost v skupini z majhno možnostjo okužbe ter v skupinah z veliko možnostjo okužbe.
BOLNIKI IN METODE. Izbrali smo tri skupine preiskovancev: eno z majhno možnostjo okužbe (10 369 nosecnic) ter dve z vecjo možnostjo okužbe (219 intravenskih uživalcev drog in 869 oseb, ki so obiskale ambulante za spolno prenosljive bolezni). Vse vzorce serumov smo najprej pregledali s presejalnim aglutinacijskim testom Serodia HTLV-I (Fujirebio, Japonska). Reaktivnost proti HTLV-I smo nato potrdili s potrditvenim Western blot testom HTLV Blot 2.4 (Genelabs Diagnostic, Singapur).
REZULTATI. Med pregledanimi 11 457 serumskimi vzorci je bil eden pozitiven (0,87 na 10 000). Pripadal je skupini z majhno možnostjo okužbe. Ce predpostavimo reprezentativnost vzorca za celotno populacijo v Sloveniji, bi lahko s 95 % gotovostjo zakljucili, da v naši državi z virusom HTLV-I ni okuženih vec kot 2,3 na 10 000 ljudi (tocen enostranski zgornji interval zaupanja IZ <0,00023). Delež okuženih smo ocenili glede na normalno porazdelitev.
ZAKLJUCKI. Po podatkih iz literature je to prvi dokazan primer okužbe z virusom HTLV-I v Sloveniji. Razširjenost okužbe z virusom HTLV-I je v naši državi nizka in primerljiva z razširjenostjo okužbe v ostalih zahodnoevropskih državah, kjer kri krvodajalcev že presejalno testirajo na prisotnost protiteles proti virusu HTLV-I.
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[Abstract / English version]
Seroprevalence of human T-cell lymphotropic
virus type I (HTLV-I) in Slovenia
Author: Jurij Bednarik, Katarina Rednak
Mentor: doc. dr. Mario Poljak, dr. med.
Co-mentor: asist.dr. Katja Seme, dr. med.
BACKGROUND. Human T-cell Lymphotropic Virus type I (HTLV-I) is classified intofamily Retrovirinae, subfamily Oncovirinae. It is transmitted with sexual intercourse, viainfected blood and from mother to child via placenta and milk feeding. T-cell leukemiaand special form of mielopathy are caused by HTLV-I. Approximately l % of infectedpersons get ill. Testing of blood donations for HTLV-I antibodies is mandatory in somecountries, on the other hand, it is not a requirement in Slovenia. This policy is based on a lowrisk of developing the disease after infection, a high number of false positive results atscreening tests and a low prevalence of HTLV-I infection among Slovenians, although thelast assumption has never been proven. The aim of our study, which was the first one in our country, was to establish seroprevalence of HTLV-I virus infection in Slovenia. We wantedto establish seroprevalence specially among low and high-risk groups.
PATIENTS AND METHODS. Three groups were chosen: one low-risk (10 369 pregnant women) and two high-risk (219 intravenous drug users and 869 patients attending venereological outpatients services). All serum samples were screened for the presence of anti- HTLV-I antibodies using commercial particle agglutination test Serodia HTLV-I (Fujirebio, Japan). Reactive serum samples were confirmed with supplemental Western blot test HTLV Blot 2.4 (Genelabs Diagnostic, Singapore).
RESULTS . Among 11 457 serum samples screened only one was found to be positive (0.87 among 10 000). It belonged to low-risk group. Assuming representativeness of the sample for all population of Slovenia, we can conclude with 95 % confidence, that less than 2,3 per 10 000 people is infected with HTLV-I in Slovenia (exact one sided upper 95 % coincidence interval CI <0,0023). The portion of infected people was estimated according to normal distribution.
CONCLUSIONS. According to data from literature this is the first proven case of HTLV-I infection in Slovenia. HTLV-I prevalence is low in Slovenia and comparable with prevalence in other Western Europian countries, where testing of blood donations for anti-HTLV-I antibodies is already mandatory.
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