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Low incidence of HTLV infections in random blood donors with indeterminate western blot patterns
S Kwok1, J J Lipka, N McKinney
1Department of Infectious Diseases, Cetus Corporation, Emeryville, California.
Abstract:
Peripheral blood mononuclear cells (PBMCs) were recovered from platelet units of 61 blood donors who were HTLV-I positive and 3 blood donors who were HTLV-I negative on enzyme-linked immunosorbent assay (ELISA). Western blot analyses were performed on the sera and DNA was prepared from the PBMCs and analyzed by the polymerase chain reaction (PCR). Of the 61 repeatably reactive samples, 2 were positive, 26 were negative, and 33 were interpreted as indeterminate on Western blot. HTLV-II sequences were detected by PCR in one of the Western blot-positive samples, as well as in one Western blot-indeterminate sample that showed reactivity to p24 only. HTLV-I sequences were detected in the second Western blot-positive sample. HTLV sequences were not detected in the remaining samples, which suggested that the majority of individuals with indeterminate results on Western blots that used one set of commercially available reagents are not infected with HTLV. It is demonstrated in this study that PCR can be used not only to resolve the infection status of individuals with indeterminate Western blots but also to distinguish between HTLV-I and HTLV-II.
Insights
Polymerase chain reaction (PCR) effectively resolves Human T-lymphotropic virus (HTLV) infection status in individuals with indeterminate Western blot results. This method distinguishes between HTLV-I and HTLV-II infections, enhancing diagnostic accuracy.
Area of Science:
- Virology
- Immunology
- Molecular Biology
Background:
- Human T-lymphotropic virus (HTLV) infection diagnosis can be challenging due to indeterminate results from standard enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) tests.
- Distinguishing between HTLV-I and HTLV-II is crucial for epidemiological and clinical management, as they have different transmission routes and associated diseases.
Purpose of the Study:
- To evaluate the utility of polymerase chain reaction (PCR) in resolving indeterminate Human T-lymphotropic virus (HTLV) Western blot results.
- To assess the capability of PCR to differentiate between HTLV-I and HTLV-II infections in blood donors.
Main Methods:
- Peripheral blood mononuclear cells (PBMCs) were isolated from blood donors screened for HTLV.
- Sera were analyzed by Western blot (WB), and DNA from PBMCs was analyzed by polymerase chain reaction (PCR).
- Comparison of results from WB and PCR to determine infection status and viral type.
Main Results:
- Among 61 initially reactive samples, 2 were WB-positive, 26 were WB-negative, and 33 were WB-indeterminate.
- PCR detected HTLV-II in one WB-positive and one WB-indeterminate sample; HTLV-I was detected in the other WB-positive sample.
- The majority of WB-indeterminate samples did not show detectable HTLV sequences by PCR, suggesting they are likely not infected.
Conclusions:
- Polymerase chain reaction (PCR) is a valuable tool for confirming HTLV infection status in individuals with indeterminate Western blot results.
- PCR effectively distinguishes between HTLV-I and HTLV-II, providing a more definitive diagnosis than serological methods alone.