Research Article: Molecular detection of human T-lymphotropic virus type 1 infection among oncology patients in Germany: A retrospective view

Date Published: May 28, 2019

Publisher: Public Library of Science

Author(s): Matias Ruggieri, Carolina Berini, Nicolas Ducasa, Miroslav Malkovsky, Paul Fisch, Mirna Biglione, Kristien Verdonck.


Human T-cell lymphotropic virus (HTLV) belongs to a larger group of primate T-cell lymphotropic viruses (PTLVs) within the family Retroviridae. It is estimated that 10 to 20 million people worldwide may be infected with HTLV-1. Although most of them are asymptomatic, around 5% of infected individuals may develop either HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) or Adult T-cell Leukaemia/Lymphoma (ATLL). Public Health authorities in many countries have implemented routine blood-donor tests for HTLV-specific antibodies; but this is not the case for Germany since the reported prevalence is very low (7/100,000). With the aim to evaluate retrospectively the presence of HTLV-1 among oncology patients in this country, samples stored at the Universitätsklinikum Freiburg, were analyzed. For this purpose, two different nested-PCR (n-PCR) protocols have been modified and set up for HTLV-1 detection. One positive case was detected by n-PCR among 406 samples (0,25%) in a period of 5 years (2008–2012) corresponding to a T-Cell Lymphoma. Despite the low prevalence, this virus is circulating in Germany, probably due to the increasing numbers of immigrants in these last years. Physicians should consider HTLV-1 infection and suspect it taking in account the ethnic and relation to endemic regions regardless the patient’s residence.

Partial Text

Human T-cell lymphotropic viruses (HTLVs) belong to a larger group of primate T-cell lymphotropic viruses (PTLVs) within the family Retroviridae. To date, four different types have been identified: HTLV types 1, 2, 3 and 4 [1]. HTLV-1 and 2 are classified into the genus Deltaretrovirus. Transmission of HTLV-1 can occur through sexual contact, blood transfusion, organ donation, sharing injecting equipment, as well as from mother-to-child (mainly through breast-feeding) [2–4].

The prevalence of HTLV-1/2 in Germany is low (about 7/100,000) even in drug users and the HTLV-1 screening of blood and organ donors is consequently not mandatory in this country [20–22]. Nonetheless, rare cases of the diseases associated with HTLV-1 (HAM/TSP and ATLL), are occasionally detected [23, 24]. Particularly, in 2013, two transplant recipients from a multi-organ donor were subsequently tested positive for HTLV-1 and developed a cutaneous T-cell lymphoma after transplantation [25].