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18-Sep-2000

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�. ��,¹ �. ��,¹ �. ��,² �. ��,² �. ��,³
�. ��,⁴ �. ��,⁵ �. ��,⁶ �. ��,⁷
�. ��,⁸ �. ��,⁹ �. ��,¹⁰ �. ��,¹¹
�. ��,¹² �. ��⁶

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⁶�� ⁷�� ⁸�' �� ⁹�� ¹⁰��
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�� (HTLV-I-��) �� , �� HTLV-I �� , �� . �� HTLV-I �� , �� .
��-�� 14 �� 90.381 �� , ��, ��, ��, �� -HTLV-I �� , �� HTLV (HERN). �� ELISA (Abbott �� Murex) �� Western blot (Pasteur �� Genelabs).
�� 9 �� (0,009%) �� 76 �� (0,08%), �� . �� 10 �� (0,01%). �� , 8 (0,008%) �� -HTLV-I �� 1 (0,001%) �� HTLV-I�. � �� . �� , �� . � �� HTLV-I� �� bar, �� . �� HTLV-I �� . � �� HTLV-I 18 �� .
�� HTLV. �� HTLV-I-��, �� , �� HTLV, �� . �� HTLV �� , � ��, �� , �� HTLV-I-�� .

�� : ��, �TLV-I-II, �� .

�� (HTLV-I �� HTLV-I�) �� .¹ �� , �� (�� ), �� .¹�� ^2�8 �� HTLV-I �� -��, �� , �� . �� HTLV-I �� Sj�gren, �� . �� HTLV-I, �� . �� HTLV-I �� HIV-1 �� , �� HTLV-I �� . � �� HTLV-I �� , �� , �� , �� , �� , ��, �� , �� .⁹ �� , �� .^10�16

� HTLV-I� �� . �� , �� , �� HTLV-I.¹⁷ �� , �� , �� .^18,19�� HTLV-I� �� . � �� -HTLV-I� �� .²⁰ �� HTLV �� , � �� HTLV-I �� , �� , �� , � ��, � ��, � ��, � �� .�.²⁰ �� , �� .^20,21� �� HTLV �� .²²

�� 1996 �� ²³ �� HTLV (HERN) �� HTLV-I �� 1:100.000 �� 30:100.000 �� HTLV-I� �� HIV-��.²³ �� R�, �� HTLV-I �� 0,2% ��, ��, �� HTLV-I �� .^23,24

�� Courouce et al,²⁵ �� 25� �� ISBT �� , �� HTLV-I �� . ��, � �� 4 �� 166 �� -HTLV-I �� 1 �� 404 �� -HTLV-I�. �� -HTLV-I �� nested PCR �� .

�� HTLV, �� , �� .^26�29 �� 1,4% �� 0,02% �� 1991�1993.³⁰

� �� HTLV-I-�� HTLV �� , �� .

�� 

�� 90.381 �� 18 �� 65 ��, �� , ��, ��, ��, �� .

�� HTLV (HERN) �� HTLV-I-�� (��. 1) �� HERN (��. 1).²³

�� ELISA (Abbott HTLV I/II EIA, �urex HTLV I/II ELISA) �� Western blot (Pasteur DLB 2.3 �� Genelabs blot 2.4). � �� HERN.²³

�� Western blot �� (HBV, HCV, HIV, ��).

� �� (��, �� ).

��

�� 2. �� 76 (0,08%) �� (47 �� , 15 �� , 12 �� 2 �� ). �� 9 (0,009%) �� (8 ��-HTLV-I �� 1 ��-HTLV-I�) �� 10 (0,01%) ��.

�� 8 HTLV-I-�� , �� 4 �� 33�52 �� 4 �� 35�51 �� (��. 3). �� . �� HTLV-I-�� . �� HTLV-I-��-�� (HBV, HCV, HIV) � �� . �� . �� , �� . � �� HTLV-I� �� 43 ��, �� bar, �� .

�� 4 �� 7 �� HTLV-I-HTLV-I�-��.

� �� , �� ' �� . � �� .

��

�� , � �� HTLV-I �� , �� , �� .²³ �� 99% �� PCR-��, �� .²³

� �� HTLV-I-�� 1:641.000.³¹ �� , �� , � �� HTLV-I �� .

��, � �� HTLV �� 0,007%,³² �� 0,003%,²⁵ �� 0,002%, �� 0,005%³³ �� 0,02%.²⁹ �� , �� ³⁴ (0,04�0,1%) �� (0,6%).³⁵ ��, �� , �� 2%, HTLV-I-�� .³⁶ �� , � �� HTLV �� HIV (0,005%)³³ �� HTLV �� HIV �� 1991�1993.^27,37 � �� HTLV �� , �� 10.000. �� , �� HTLV-I-�� , �� , �� .²³

� �� -HTLV-I� �� -HTLV-I-�� , �� , �� 1,8�8,9% �� HTLV-I�.¹²

�� 0,4�11,5%,³⁸ �� 0,5�5,3%,^39,40 �� 0,67�7,5%^41,42 �� 6,5%.⁴³

�� , � �� , � �� , �� , �� . �� HTLV-I �� , �� . �� HTLV-I �� , �� , �� 100�1000 �� , �� HTLV �� 25% �� 5%.^44,45

�� , �� HTLV �� . �� , �� 1987�1990 �� HTLV, �� , �� (1/159) �� .^26,27

�� , �� 1991�1993, �� -HTLV-I �� (5/357) �� 2/11500 �� (0,02%) �� 1 �� .^29,30

�� 90.381 �� , �� 0,009% �� HTLV-I �� , �� -HTLV-I� �� . � �� .

�� -HTLV-I (+) �� -HTLV-I� (+) �� , �� bar �� . �� /�� HTLV-I �� 18 ��. �� .

�� HTLV-I-��, �� , �� HTLV, �� . �� HTLV �� , � ��, �� , �� HTLV-I-�� . �� HTLV-I-�� , � �� -�� -HTLV-I-��. � �� , �� , �� . �� .⁴⁶

��

WORLD HEALTH ORGANIZATION. Virus diseases. Human T-cell lymphotropic virus I (HTLV-I). Weekly Epidemiol Rec 1992, 67:213� 217
NAKAO K, OHBA N. Clinical features of HTLV-I associated uveitis. Br J Ophthalmol 1993, 77:274�279
WYLD PJ, TOSSWILL JH, MORTIMER PP, WEBER JN. Sporadic HTLV-I associated adult T-cell leukemia (ATL) in the UK. Br J Haematol 1990, 76:149�150
FAUIN R, MINUTILLO S, D'AGARO R ET AL. HTLV-I positive adult T-cell leukemia-lymphoma: a report of a typical case from Italy. Hematologica 1990, 75:375�380
SENJUTA N, PARLISH O, GURTSEVITCH V. Case of adult T-cell leu kemia infected family in Georgia, USSR. Lancet 1991, 338:1394
GONT O, BANLAC M, GESSAIN A. Rapid development of myelopathy after HTLV-I infection acquired by transfusion during cardiac transplantation. N Engl J Med 1990, 332:383�387
SHULTZ T, WEBER I. Epidemiology of HTLV-I. In: Daligliesh, Weiss (eds) AIDS and the new viruses. London, Academic Press, 1990: 135�162
GALLO RC. Human retroviruses. A decade of discovery and link with human disease. J Infect Dis 1991, 164:235�243
MANNS A, BLATTNER WA. The epidemiology of the human T-cell lymphotropic virus type I and type II: etiology role in human disease. Transfusion 1991, 31:67�75
PAGLINCA A, PAWSON R, MUFTI GJ. HTLV-I screening in Britain. Br Med J 1995, 311:1313�1314
GIESECKE J. HTLV screening of Swedish blood donors. Lancet 1995, 345:978
BUSCH MP, LAYCOCK M, KLEINMAN SH. Accuracy of supplementary serologic testing for human T-lymphotropic virus types I and II in US blood donors. Blood 1994, 83:1143�1148
LEVINE PH, BLATTNER WA, CLARK J, TARONE R, MAHONEY EM, MURPHY EM ET AL. Geographic distribution of HTLV-I and identification of a new high-risk population. Int J Cancer 1988, 42:7�12
COUROUCE AM, PILLONEL J, LEMAIRE JM, MANIER M, BRUNNET JB. Seroepidemiology of HTLV-I-II in universal screening of blood donations in France. AIDS 1993, 7:841�847
VLAHOV D, KHABBAZ RF, COHN S, GALAI N, TAYLAR E, KAPLAN JE. Incidence and risk factors for human T-lymphotropic virus, type II (HTLV-II) seroconversion among injecting drug users in Baltimore, Maryland. J AIDS 1993, 7:841�847
VAN DEN HOCK JAR, AI EJM, HUISMAN JG, GOUDSMIT J, GOUTINHO RA. Low prevalence of human T-cell leukemia virus I and II infection among drug users in Amsterdam, the Netherlands. J Med Virol 1991, 34:100�103
KALYANARAM VS, SARNGADHARAN MC, ROBERT-GUROFF M, MIYOSHI I, BLAYNEY D. A new subtype of human T-cell leukemia virus (HTLV-II) associated with a T-cell variant of hairy cell leukemia. Science 1982, 218:571�573
GOUBAN P, LIU HF, DE LANGE GG, VANDAMME AM, DESMYTER J. HTLV-II seroprevalence in Pygmies across Africa since 1970. AIDS Res Human Retroviruses 1993, 9:709�713
HALL WW, ZHU SW, HORAL P, FURUTA Y, ZAGAANY G, VAHINE A. HTLV-II infection in Mongolia. 6th International Conference on Human Retrovirology 1994. AIDS Res Human Retroviruses 1994, 10:433 (Abstract)
HABIBI B. HTLV-I-II screening mandatory in France. Transfus Today 1991, 11:8
TAYLOR GP. The epidemiology of HTLV-I in Europe. J Acquir Immune Def Syndr Hum Retrovirol 1996, 13:68�77
COUNCIL OF EUROPE. Committee of Experts on Blood Transfusion and Immunohematology and Select Committee of Experts on Automation and Quality Assurance in Blood Transfusion Services. SP-HM 1995, (25)15
THE HTLV EUROPEAN RESEARCH NETWORK. Seroepidemiology of the human T-cell leukemia-lymphoma viruses in Europe. J Acquir Immune Def Syndr Hum Retrovirol 1996, 13:68�77
COURTOIS F, BARIN F, LARSEN M, BRASSARD X, MASSELIN A, ENGELMAN P. HTLV-I/II infection in pregnant women in Paris. Lancet 1990, 335:1103
COUROUSE AM, PILLONEL J, LEMAIRE JM, SAURA C. HTLV testing in blood transfusion. Vox Sang 1998, 74(Suppl 2):165�169
�� , �� , �� , ��-�� , �� , �� . �� -�� (HTLV-I) �� . 1� �� AIDS �� , ��, �� , 1990:35
POLITIS C, PAPAEVANGELOU G, SINAKOS Z, TRICHOPOULOU E, ROUMELIOTOU A. HTLV-I infection in multi-transfused patients with thalassemia. Transfusion 1989, 29:561
DELEKOS GN, ZERVOU E, KARABINI F, ELISA M, BOURANTAS K, SIAMO POULOS K. Prevalence of antibodies to human T-lymphotropic virus types I and II in volunteer blood donors and high-risk groups in northwestern Greece. Transfusion 1995, 35:503�506
�� , �� , �� , �� , RICHARDSON C, �� . �� HTLV-I/�� . �� 1993, 63:502�507
POLITIS C, ECONOMIDOU I, PAPADOYANNAKI N, RICHARDSON C, FRAGATOU S, VRETTOU E ET AL. HTLV-I infection in blood donors, thalassemia patients and renal patients in Greece. Arch Hell Med 1996, 13:388�392
SCHREIRER GB, BUSCH MP, KLEINMAN SH. The risk of transfusion-transmitted viral infections. N Engl J Med 1996, 334:1685�1690
MANNELLA E, MICELI M, DI LORENZO A, PODAGROSI D, MERCURIO G, GALLO A. Prevalenza delle infezionida HTLV-I e HTLV-II in donatori di sangue. AIDS 1993, 4:219�223
BRENNAN M, RUNGANGA J, BARBARA JAJ, CONTRERAS M, TEDLEZ RS, GARSON JA ET AL. Prevalence of antibodies to human T-cell leukemia/lymphoma virus in blood donors in north London. Br Med J 1993, 307:1235�1239
SHIH J, SENJUTA N, STEPINA X, YAKOVLEVA L, GURSEVITCH V. HTLV seroprevalence in regions of the former USSR. Proceedings IX International Conference on AIDS, Berlin, 1993:683
PAUN I, ISPAS D, DEL MISTRO A, CHIECO-BIANCHI L. HTLV-I in Romania. Eur J Hematol 1994, 52:117�118
REZVAN H, AHMADI J, FARHADI M. A "cluster" of HTLV-infection in north-eastern Iran. Transfus Today 1996, 27:8�9
HATZIDIMITRIOU K, KONTOPOULOU K, MANDALAKI T. HIV seropositivity in Greek blood donors 1985�1990. Vox Sang 1991, 61: 215�216
PADUA E, AVILLEZ F. Estudo de prevalencia da Infeccao pro HTLV-I. Rev Port Doenc Inf 1992, 15:177�179
ZELLA D, MORI L, SALA M. HTLV-II infection in Italian drug users. Lancet 1990, 336:575�576
CALABRO MI, LUPARELLO M, GROTTOLA A. Detection of human T-lymphotropic virus type II/b in human immunodeficiency virus type I infected persons in Southeastern Italy. J Infect Dis 1993, 168:1273�1277
BLOMBERG J, MOESTRUP T, FRIMAND J. HTLV-I and II in intravenous drug users from Sweden and Denmark. Scand J Infect Dis 1994, 26:23�26
KROOK A, BLOMBERG J. HTLV-II among infecting drug users in Stockholm. Scand J Infect Dis 1994, 26:129�132
GOUBAU P, WANTZIN P, GESSAIN A, JEANNEL D, COSTE J, PAULI G ET AL. Seroepidemiology of the human T-cell leukaemia/lymphoma viruses in Europe. J Acquir Immune Def Syndr 1996, 13:68�77
ANDO Y, SAITO K, NAKANO S. Bottlefeeding can prevent transmission of HTLV-I from mothers to their babies. J Infect 1989, 19: 25�29
TOSSWILL JHC, ADES AE, PECKHAM C, MORTIMER P, WEBER JN. Infection with HTLV I in patients attending an antenatal clinic in London. Br Med J 1990, 301:95�96
CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE USPHS WORKING GROUP. Guidelines for counselling persons infected with human T-lymphotropic virus type I (HTLV-I) and type II (HTLV-II). Ann Intern Med 1993, 118:448�454

� 2000, ��