Human T-Cell Lymphotropic Virus Type I AND II (HTLV-I/II) Infection Among Blood Donors AT THE NATIONAL BLOOD SERVICE (NBSG); IMPLICATION FOR BLOOD DONOR Exclusion

ABSTRACT

Background: The human T-cell lymphotropic/leukemia virus (HTLV) was button down in 1980 by Poiesz et al. HTLV are a group of human retroviruses that are known to cause a type of cancer called adult T-cell leukemia/lymphoma (ATL) and also a demyelinating disease called HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). There are four main types of HTLV, thus, HTLV-I, HTLV-II, HTLV-III and HTLV-IV. About 10-20 million people are infected with HTLV I and II across the globe. The main modes of transmission of the virus is by mother to child (through breastfeeding), sexual intercourse, sharing of infected needles among drug users and lastly by blood transfusion. HTLV-I and II mostly infect CD4+ and CD8+ T-cells respectively. Reported seroprevalence of HTLV among Ghanaian blood donors over the past ten years is between the ranges of 0.5%-4.2%. Blood donors in Ghana and Africa as a whole are still not screened for HTLV-I and II since the report of the discovery of the virus. This therefore serves as a risk factor for transmitting the virus to blood recipients through infected blood. Aim: To determine the prevalence of HTLV-I and II antibodies among blood donors at the national blood service, Ghana. Methods: The research design was a descriptive prospective cross sectional study involving 300 consecutive voluntary blood donors from the southern area blood centre of the National Blood Service, Ghana (NBSG). The study used stored (-20˚C) sera separated from 3ml of blood samples obtained from voluntary blood donors at the National Blood Service, Ghana (NBSG) who had consented to join the study orally by writing and who had been proven to be in good health to donate. HTLV-I and II antibodies were duplicately screened for using an enzyme linked immunosorbent assay as a screening test. A well structured questionnaire was also administered ii to the voluntary blood donors to obtain some basic information such as age, gender, marital status, occupation and their frequency of donating blood. The statistical software SPSS version 20 was used to generate the descriptive analysis of the results obtained. Results: With the total 300 voluntary blood donors sera samples tested, 10(3.3%) were positive for anti-HTLV-I/II. The ages of the donors ranged between 18-59 years. The majority 104(34.7%) of the donors were in the age range of 25-31 years, and the age range with the least number of donors was 53-59 years 5(1.7%). Three females (3.8%) were infected out of 78(26%) while 7(3.2%) out of 222(74.0%) males were infected. Majority of the donors were single 200(66.7%) and 6(3.0%) out of the total unmarried donors 200(66.7%) tested positive while 96(32.0%) were married and 4(4.2%) of them were infected. Two hundred (66.7%) of the total participants of the study were first time donors and none (0.0%) of those were infected while 34(11.3%) were frequent donors with more than 3 blood donations had 7(20.6%) of them testing positive. Conclusion: This study therefore reports an HTLV-I/II seroprevalence of 3.3%. The findings of this study implies that, HTLV-I/II occurs among apparently healthy voluntary blood donors at the southern area blood centre of the national blood service Ghana. Thus, there’s the need to conduct a nationwide large population based research on the same HTLV-I/II infection among voluntary blood donors so as to determine or ascertain the exact prevalence and then determine whether to screen for the virus or not among blood donors.