Serologic and molecular typing of human T-lymphotropic virus among blood donors in Maputo City, Mozambique

BACKGROUND: Screening for human T‐lymphotropic virus‐1/2 (HTLV‐1/2) infection is not performed in blood banks in Mozambique. The aim was to determine the prevalence of HTLV‐1/2 among blood donors of the Maputo Central Hospital Blood Bank and measure the coinfection rate of HTLV‐1/2 with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis. STUDY DESIGN AND METHODS: A total of 2019 consecutive blood donors were screened for HTLV‐1/2 antibodies, HIV‐1/2 antibodies, hepatitis B surface antigen (HBsAg), and rapid plasma reagin (RPR) for syphilis. Specimens reactive on a first HTLV‐1/2 enzyme immunoassay (EIA) were retested using a second EIA. Specimens that were dually reactive on both EIAs were further tested using Western blot (WB) and real‐time polymerase chain reaction (PCR). RESULTS: All 18 dually reactive specimens (0.89%; 95% confidence interval, 0.48%‐1.30%) were positive for the presence of HTLV‐1 by WB and real‐time PCR. HTLV‐2 was not detected. The prevalences of anti‐HIV, HBsAg, and reactivity in the RPR test were 5.72, 6.01, and 0.98 percent, respectively. There was no significant association between HTLV‐1 infection and demographic variables (age and sex) or serologic markers (HIV, HBsAg, and RPR). For the 17 HTLV‐1–positive donors for whom serologic data for HIV, HBsAg, and syphilis RPR were available, 2 showed coinfection with HIV and 1 with HBV. CONCLUSION: Compared to other infectious agents, HTLV‐1 is present at relatively low levels among blood donors in Mozambique. Cost and logistics will present as major challenges for introducing HTLV‐1/2 screening in blood banks. In blood banks in Southern Africa where EIA testing is possible, a sequential algorithm of two EIAs may be a cost‐efficient option for HTLV‐1/2 screening.