Human T-lymphotropic virus-1 proviral load among patients on maintenance hemodialysis

Human T-lymphotropic virus type 1(HTLV-1) is a complicated leukemogenic retrovirus, it is the first oncogenic virus discovered and identified as the leading cause of T-cell malignancy and HTLV related myelopathy with a long latency period. Transmission via infected blood products is one of the common routes of HTLV-1 infection, and hemodialysis patients are potentially more vulnerable to blood-borne viral infections such as HTLV. This study aimed to determine the factors associated with HTLV-1 proviral load among hemodialysis patients.

A cross-sectional study of 130 patients undergoing hemodialysis was conducted between November 2023 and January 2024. After HTLV-1 RNA extraction, complementary DNA (cDNA) was synthesized. HTLV-1 pro-viral load (PVL) was quantified by real-time PCR (qRT-PCR).

HTLV-proviral load was detected in 57 (43.84%) blood samples, with a mean ± standard deviation (SD) of 16.3×103 ± 5.4×104(copies/μL), including 34 (26.2%) males and 23 (17.7%) females. The highest percentage of infection (22.3%) was detected in the 40-59 age group and married patients (39.2%); however, a high viral load was observed in the 20-39 age group. Frequent blood transfusions associated with HTLV-1 infection were observed in 42 patients (32.3%). Myelopathy-related muscle spasms and paresthesia were significantly associated with the HTLV-1 viral load (p<0.05). A statistically significant relationship was observed between asymptomatic patients and high HTLV-1 proviral load (p=0.004).

These findings show that a significant number of dialysis patients were infected with HTLV-1. Therefore, hemodialysis patients should be frequently screened for HTLV-1 infections.