Relative prevalence and risk factors of HTLV-I and HTLV-II infection in US blood donors

H. H. Lee, P. Swanson, J. D. Rosenblatt, I. S.Y. Chen, W. C. Sherwood, D. E. Smith, G. E. Tegtmeier, L. P. Fernando, C. T. Fang, M. Osame, S. H. Kleinman

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95 Scopus citations


The clinical significance of human T-cell lymphotropic virus type II (HTLV-II) infection, unlike that of HTLV-I, is unknown, and the major known association of HTLV-II seropositivity is with intravenous drug abuse. Screening of blood donors for HTLV-I, now routine in North America, does not distinguish this retrovirus from HTLV-II. To find out more about the seroepidemiology of and risk factors for HTLV I and II, blood from 480 000 volunteer donors in five geographically separate US urban centres was tested for antibodies to HTLV-I/II and HIV-1. Confirmed HTLV-I/II seropositive donors were then followed up by DNA amplification to distinguish type I from type II and by interviews focusing on possible risk factors. HTLV seroprevalence was 3·3 times greater than that for HIV-1 (0·043% vs 0·013%). DNA amplification on 65 of the 207 HTLV-I/II seropositive donors revealed that 34 (52%) had HTLV-II infection and 28 (43% had HTLV-I; 3 samples were uninformative. Interviews of 49 donors showed that whereas HTLV-I was principally associated with donor origin from endemic regions, the major risk factor for HTLV-II infection was intravenous drug use. The surprisingly high rate of HTLV-II infection in US blood donors raises important public health and donor counselling issues since HTLV-I infection is associated with adult T-cell leukaemia and a neurological disorder while the pathogenicity of HTLV-II is as yet unclear.

Original languageEnglish (US)
Pages (from-to)1435-1439
Number of pages5
JournalThe Lancet
Issue number8755
StatePublished - Jun 15 1991
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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