Abstract
Human T-cell lymphotrophic virus III (HILV-III), or human immunodeficiency virus (HIV), is the causative agent of acquired immunodeficiency syndrome (AIDS), Human T-cell lymphotrophic virus I (HILV-I) is the cause of adult T cell leukemia (ATL). Patients on hemodialysis (HD) may constitute a high-risk group for infection with HTLV-III and HTLV-I because of their frequent blood transfusions. In this study, we investigated the risk of infection with HTLV-III or HTLV-I by testing for antibodies aganist them in 249 patients on chronic HD. Assays for antibodies to HTLV-III and HTLV-I were performed by enzyme immunoassay (EIA, Abbott) and the particle agglutination method (PA, Fuji Rebio), respectively. Positive samples were confirmed by Western blotting.
No patient had antibodies to HTLV-III. On the other hand, 14 patients (5.6%) had antibodies to HTLV-I. This percentage was significantly higher than that of healthy donors in Tokyo and Saitama (0.77%). However, when patients were divided into three groups according to the kind of blood transfusion, group I, who had no evidence of transfusion, group II, who received leukocyte-depleted red cells, and group III, who received leukocyte-rich red cells, such as concentrated red cells, the number of HTLV-I antibody-positive patients was significantly less in groups I (2.7%, 2/73) and II (2.0%, 2/99) than in group III (13.0%, 10/77). A high incidence of HTLV-I infection was observed in patients transfused mainly leukocyte-rich red cells.
These results suggest that leukocyte-depleted red cells should be transfused to anemic patients on HD to avoid blood-transmitted viral infections-not onlly HTLV but also unknown viruses which might be present in a latent state in leukocytes.
