oa Molecular Diagnosis and Vaccines - Association of human T-cell lymphotropic virus type 1 infection with T-cell leukemia and lymphoma in adult Egyptian patients
Human T-cell Lymphotropic virus type 1 (HTLV-1) is causally associated with adult T-cell leukemia/lymphoma (ATLL), an aggressive T-cell malignancy with a poor prognosis. The aim of this study is to study the association of HTLV-1 infection with Egyptian cases of T cell leukemia/ lymphoma. The study was conducted on ninety subjects, involved two groups; group I included sixty adult Egyptian patients with T cell leukemia or lymphoma who attended Hematology & Oncology Units at Ain-Shams University, El Maady Military Hospital, and National Institute for Cancers. Group II were thirty apparently healthy individuals as a control group. Enzyme linked immunosorbent assay (ELISA) was done for detection of circulating antibodies against HTLV-1 in human sera in patients and control groups. It was found that seven (11.7 %) out of 60 patients and one control person (3.3%) were serologically positive by ELISA technique. All serologically positive samples (n=8) and randomly selected negative samples from both patients (n=33) and control groups (n=9) were confirmed by polymerase chain reaction (PCR) for the detection of HTLV-1 proviral DNA in the peripheral blood mononuclear cells (PBMNCs). Three serum samples (3/40; 7.5%) from patients with T cell leukemia/ lymphoma were determined to be positive for HTLV-1 proviral DNA by PCR, while none of the control group samples showed reactivity to PCR. The specificity of ELISA was 90.2% and sensitivity was 100%, while specificity and sensitivity of PCR was 100%. The three patients positive for HTLV-1 proviral DNA were males, their ages ranged from 46-60 (mean 48), two of them (66.7%) were diagnosed as T-cell lymphoma of ATLL-type and one (33.3%) was acute Leukemia of ATLL-type. Two of them (2/3; 66.7%) had a history of blood transfusion. We conclude that Human T -cell Lymphotropic virus type 1 (HTLV-1) is probably associated and may be causally related to some cases of adult Egyptian patients afflicted with T cell leukemia /lymphoma and testing for HTLV-1 may be of help in establishing such a relation, in assessing the prognosis and risk stratification for optimum management. Although ELISA is a sensitive, reliable, and cost-effective technique for diagnosis of HTLV-I infection, positive ELISA results should be confirmed by PCR. Further epidemiological and interval studies to nationally assess HTLV-1 infection should be initiated and preventive measures to decrease the spread and transmission of HTLV-1 are warranted in Egypt.
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