oa Southern African Journal of Infectious Diseases - Health policy implications of blood transfusion-related human T-cell lymphotropic virus type 1 infection and disease : case report
Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent for HTLV-1-associated myelopathy (HAM) or tropical spastic paraparesis (TSP), and adult T-cell leukaemia (ATL). The virus is transmitted vertically from mother to child, and horizontally by sexual intercourse and the transfusion of blood. We describe a case of HAM/TSP, thought to have been acquired by blood transfusion. The South African National Blood Transfusion Services (SANBS) does not currently offer routine screening for HTLV-1. We searched the literature for surveillance studies, and asked the SANBS to provide us with data from any unpublished studies. We identified one study published by the Natal Blood Transfusion Services in 1990, and the SANBS provided us with data from studies conducted in 1996 and 2013. None of the donors were found to be positive from the 5 603 donors who were tested in 1990. This study included 1 502 black, 2 569 white, 102 coloured and 1 430 Asian donors. Three donors out of 37 496 were found to be positive in 1996. Sixty donors were found to be positive in the 2013 survey in which 46 764 donors were tested. The rates in the different population groups in the most recent survey were as follows: black Africans [58 in 34 176 (0.17%)], whites [1 in 5 644 (0.02%)], coloured (mixed ancestry) [1 in 6 038 (0.02%)] and Asians of Indian descent [0 in 909 (0%)].
The changing HTLV-1 seroprevalence data with respect to South African blood donors provides compelling evidence for the need for the introduction of routine screening of HTLV-1 by the SANBS.
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