Delayed seroconversion and rapid onset of lymphoproliferative disease after transmission of human T-cell lymphotropic virus type 1 from a multiorgan donor.

Abstract

BACKGROUND:

Human T-cell lymphotropic virus type 1 (HTLV-1) screening of blood and organ donors is not mandatory in Germany because of its low prevalence (about 7/100 000). An HTLV-1 transmission event caused by a multiple organ donor was investigated. Validity of diagnostic procedures and HTLV-1 disease association in immunosuppressed organ recipients were analyzed.

METHODS:

Two screening immunoassays and an immunoblot (confirmatory assay) were used for detection of HLTV-1/2 antibodies. Proviral DNA was quantified in blood and biopsies of organ recipients by HTLV-1 real-time polymerase chain reaction (PCR).

RESULTS:

Proviral HTLV-1-DNA was detected in all blood samples of 3 organ recipients (1-100 copies/10(2) cells), but seroconversion was delayed for up to 2 years in screening assays and >6 years in the confirmatory assay. In 2 of 3 organ recipients, a cutaneous T-cell lymphoma was diagnosed 2 and 3 years after infection, respectively. Proviral HTLV-1 DNA concentration was almost 100 copies/10(2) cells in cutaneous lymphoma biopsies whereas in biopsies of other tissues ≤3.0 copies/10(2) cells were found. The third organ recipient did not suffer from lymphoma, but detailed clinical data on this patient were not available to us.

CONCLUSIONS:

Biopsy results support an etiological role for HTLV-1 in these cases of primary cutaneous T-cell lymphoma after solid organ transplant. HTLV-1-associated lymphoma can arise quickly in immunocompromised transplant recipients. The diagnosis of potentially HTLV-1-associated disease in organ recipients may require PCR because of delayed seroconversion.

• Authors: Ilona Glowacka, Klaus Korn, Sebastian A Potthoff, Ulrich Lehmann, Hans H Kreipe, Katrin Ivens, Hannelore Barg-Hock, Thomas F Schulz, Albert Heim
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 57 Issue 10 Pg. 1417-24 (Nov 2013) ISSN: 1537-6591 [Electronic] United States
• PMID: 23956168 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral
• DNA, Viral

Topics

• Antibodies, Viral (blood)
• DNA, Viral (analysis)
• Female
• HTLV-I Infections (blood, virology)
• Human T-lymphotropic virus 1 (isolation & purification)
• Humans
• Lymphoma (blood, virology)
• Male
• Middle Aged
• Skin (chemistry, immunology)
• Tissue Donors
• Transplantation (adverse effects)