Transfusion transmission of retroviruses: human T‐lymphotropic virus types I and II compared with human immunodeficiency virus type 1

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Abstract
Background: The incidence of transfusion transmission of human T‐ lymphotropic virus type I (HTLV‐I) and HTLV type II (HTLV‐II) has not been compared directly or to that of human immunodeficiency virus type 1 (HIV‐1). The effects of refrigerator storage of the blood component on infectivity of the viruses needs definition. Study Design and Methods: The circumstances influencing the transmission of HTLV‐I, HTLV‐ II, and HIV‐1 via blood of donors whose sera were stored in a repository and who were retrospectively documented as having been infected at blood donation were examined. Confirmation and typing of anti‐HTLV positivity in donors and recipients used polymerase chain reaction, supplemented by specific peptide testing. Results: Overall, 27 percent (26/95) of the recipients of blood components from anti‐HTLV‐ I‐ and ‐II‐positive donors became infected (9 with HTLV‐I and 17 with HTLV‐II). No recipients of acellular blood components became infected with HTLV‐I or ‐II. There was no probable transmission by components stored > 10 days. The rates of transmission for both viruses were similar: 0 to 5 days' storage, 17 (74%) of 23; 6 to 10 days, 8 (44%) of 18; and 11 to 14, 0 (0%) of 10 (trend, p = 0.0002). In comparison, 89 percent (112/126) of the recipients of anti‐HIV‐1‐positive blood were infected regardless of component type, and no effect on transmission occurred with storage for < 26 days. Conclusion: Transfusion‐ transmitted HTLV‐I and ‐II are similar. The data suggest that a donor's lymphocytes become noninfectious when they lose the ability to be activated or to proliferate.