Intrafamilial Transmission and Risk Assessment of HTLV-I among Blood Donors in Southern Taiwan

人類嗜T淋巴球病毒第一型(HTLV-I)在南台灣捐血者其家族內感染情形及危險性評估

盧世乾(Shih-Chien Lu) ； 高全良(Chuan-Liang Kao) ； 金立德(Li-Te Chin) ； 陳仁偉(Jen-Wei Chen) ； 楊俊茂(Chun-Mao Yang) ； 張貞祥(Andrew C-H Chang) ； 陳百薰(Bai-Hsiun Chen)

《The Kaohsiung Journal of Medical Sciences》 17卷3期 (2001/03) Pp. 126-132

https://doi.org/10.6452/KJMS.200103.0126

摘要

人類嗜Ｔ淋巴球病毒第一型（ＨＴＬＶ－Ｉ）是成人Ｔ細胞白血病／淋巴瘤及人類嗜Ｔ淋巴球病毒有關肌肉及神經瘓癱疾患（ＨＡＭ／ＴＳＰ）的主要病因，然而此病毒其在ＨＴＬＶ帶原者之家族內感染情形在台灣仍少有報告。本研究擬探討在台灣ＨＴＬＶ－Ｉ血清陽性捐血者其病毒在家族內感染情形並評估ＨＴＬＶ－Ｉ帶原者親人之危險因子。吾人從台南捐血中心收集二十位ＨＴＬＶ－Ｉ血清陽性捐血者及其一百零三位親予以面談、填寫問卷並抽血檢測。１０３位ＨＴＬＶ－Ｉ帶原者親人中有４０位（38.8%）呈陽性，其年齡分佈自一歲至七十歲，平均年齡為31.0±1.65歲。男性ＨＴＬＶ－Ｉ帶原者十位太太中之三位呈陽性，而女性帶原者六位先生中無一位呈陽性。經分娩過程由母親傳小孩之ＨＴＬＶ－Ｉ垂直感染於２０家族４８個檢測者中有９位（18.8%）。ＨＴＬＶ－Ｉ感染在帶原者之親人中之有意義的危險因子為曾住院、曾輸過血、曾以母乳餵哺、Ｃ型肝炎抗體陽性以及女性親人年紀超過三十歲者，其odds ratio分別為9.73，8.64，4.36，8.86及4.91。ＨＴＬＶ－Ｉ感染重要非危險性因子則包括曾共用針頭、曾開過刀、Ｂ型肝炎表面抗原陽性以及男性帶原者親人超過三十歲者。吾人研究顯示在台灣ＨＴＬＶ－Ｉ由母親傳小孩以及先生傳太太之傳染方式為家族內感染之重要途徑。對ＨＴＬＶ－Ｉ陽性捐血者之家人作此項篩選應有必要。

並列摘要

The human T-lymphotropic virus type 1 (HTLV-I) is one of the important etiological agents of adult T -cell leukemia/lymphoma and of HTL V -1 associated myelopathy or tropical spastic paraparesis. There is still a lack of data. concerning HTLV-I transmission by seropositive carriers in Taiwan. We investigated the patterns of HTLV-I intrafamilial transmission in HTLV-I seropositive blood donors and assessed the risk factors of HTLV-I transmission in relatives of HTLV- I carriers in Taiwan. A total of twenty HTLV-I seropositive donors and their 103 relatives were enrolled. Among those 103 relatives, 40 (38.8%) were seropositive for HTLV-I. Their ages ranged from one to 70 years old with a mean age of 31.0±1.65 year-old. Three of the ten wives of male carriers were HTLV-I seropositive. However, none of the six h us bands of female carriers were HTLV-I seropositive. Mother-to-child vertical transmission was found in nine of 48 (18.8%) tested. Significant risk factors of HTLV-I transmission among relatives of HTLV-I carriers were hospital admission, previous transfusion, breast feeding, anti-HCV seropositivity and female relatives of age ＞/= 30 with odds ratio (OR) of 9.73,8.64,4.36,8.86 and 4.91, respectively (all p ＜ 0.05). Nonsignificant risk factors of HTLV-I transmission were sharing needles, operation history, HBsAg seropositivity and male relatives of age ＞/= 30. Our findings suggest that mother-to-child and husband-to-wife transmissions are the important forms of intrafamilial transmission of HTLV-I in Taiwan. Screening for HTLV-I in family members of HTLV-I seropositive blood donors may be warranted.

並列關鍵字

HTLV ； familial transmission ； donor ； risk