Human T-Lymphotropic Virus: What Your Positive Test Means

Human T-lymphotropic virus (HTLV)

Hello doctor, I have been consistently donating blood and have done so 12 times.
The reports for the first 11 times were normal, but this time the blood donation report tested positive for Human T-Lymphotropic Virus (HTLV).
My 11th donation was in May and the 12th in October.
During this period, I contracted COVID-19 and influenza A, had a motorcycle accident, and received treatment for asthma, including receiving an influenza A infusion and a tetanus shot.
I researched the transmission routes, but I have not engaged in sexual activity, received blood transfusions, or breastfed.
I'm wondering if the positive result is due to the vaccinations I received, or if I have had the virus all along, and why the previous tests were negative.
Is it possible for this to disappear? Thank you.

Pingguo, 20~29 year old female. Ask Date: 2023/12/02

Dr. Liao Zhongxin reply Internal Medicine

1.
What is a "Human T-lymphotropic virus" (HTLV) carrier? Human T-lymphotropic virus (HTLV), primarily classified into HTLV-I and HTLV-II, is screened for antibodies at blood donation centers using enzyme immunoassays.
Individuals who test positive for HTLV antibodies through serological testing after infection are referred to as HTLV carriers.
Carriers are infectious and can transmit the virus through breast milk, blood, or other bodily fluids.
The current infection rate of HTLV-I in Taiwan is approximately 0.4% to 0.5%, while the infection rate of HTLV-II remains unclear.
2.
How is HTLV transmitted? (HTLV refers to both HTLV-I and HTLV-II)
1.
Breastfeeding: An infected mother can transmit the virus to her newborn through breast milk.
2.
Sexual contact: Infection can occur through sexual contact with an HTLV carrier.
3.
Instrumental transmission: Sharing needles, syringes, and instruments used in surgeries, acupuncture, or tattooing that are contaminated with HTLV carrier blood can lead to infection.
4.
Blood transfusion: Receiving blood or blood components from an HTLV carrier can result in infection.
3.
What diseases can HTLV infection cause? HTLV can lead to lifelong persistent infection.
Approximately 95% of HTLV carriers will never develop symptoms, while only 5% will experience disease.
HTLV-I has been confirmed to cause two diseases: Adult T-cell leukemia/lymphoma (ATL/L) and a neurological condition known as Tropical Spastic Paraparesis/HTLV-associated Myelopathy (TSP/HAM); however, the incidence rates are low, at 2% to 4% and less than 1%, respectively.
The pathogenicity of HTLV-II is still unclear.
4.
How to prevent HTLV infection and precautions for carriers:
1.
Avoid unnecessary blood transfusions.
2.
HTLV carriers should not donate blood.
3.
If the mother is an HTLV carrier, breastfeeding should be avoided.
4.
Inform the physician before donating sperm or any organs or tissues.
5.
Practice safe sex by using condoms consistently.
6.
Do not share needles with others.
7.
Use sterile disposable plastic syringes; do not "just change the needle without changing the syringe."
8.
Avoid unnecessary injections, acupuncture, tattoos, etc.
9.
Medical instruments such as acupuncture needles and surgical tools should undergo special sterilization, not just soaking in disinfectant.
10.
Properly dispose of used syringes, needles, and disposable medical equipment to prevent contamination.

If none of the above risky behaviors have occurred and HTLV-1 remains positive, it is recommended to seek further consultation and testing at a medical facility with a hematology-oncology department.

Reply Date: 2023/12/02

More Info

Human T-Lymphotropic Virus (HTLV) is a retrovirus that can lead to serious health issues, including adult T-cell leukemia/lymphoma and tropical spastic paraparesis. A positive test for HTLV antibodies indicates that you have been exposed to the virus at some point in your life. However, it does not necessarily mean you are currently infected or that you will develop any related diseases.

Your situation raises several important points regarding HTLV and its implications. First, it’s essential to understand how HTLV is transmitted. The primary modes of transmission include sexual contact, sharing needles, and from mother to child during childbirth or breastfeeding. Given that you mentioned you have not engaged in sexual activity, received blood transfusions, or breastfed, it is less likely that you contracted the virus through these common routes. However, it is important to note that HTLV can also be transmitted through other means, such as sharing personal items that may have come into contact with infected blood.

The fact that you have had previous negative tests for HTLV suggests that you may have been exposed to the virus more recently, or that your body has developed antibodies in response to an infection that was not previously detected. It is also possible that the antibodies were present at low levels in your earlier tests, which may not have been sensitive enough to detect them. The immune response can vary from person to person, and factors such as stress, illness, or even vaccination can influence antibody levels.

Regarding your concerns about whether the positive test could be related to recent vaccinations or treatments, it is unlikely that vaccinations for influenza or tetanus would cause a false positive for HTLV. Vaccines generally do not contain live viruses that would trigger an HTLV antibody response. However, it is always a good idea to discuss any recent medical treatments or vaccinations with your healthcare provider, as they can provide personalized insights based on your medical history.

As for whether the HTLV antibodies will disappear, it is important to understand that once you have been exposed to HTLV, the antibodies may remain in your system for a long time, even if the virus is not actively replicating. In some cases, individuals may remain asymptomatic carriers of the virus without ever developing related diseases. Regular monitoring and follow-up testing are essential to assess your health status and determine if any further action is needed.

Given your positive test result, it is advisable to consult with a healthcare provider who specializes in infectious diseases or a hematologist. They can perform additional tests, such as a Western blot test or PCR (polymerase chain reaction) test, to confirm the presence of the virus and assess your overall health. They can also provide guidance on lifestyle modifications and monitoring strategies to ensure your well-being.

In summary, a positive HTLV test indicates exposure to the virus, but it does not necessarily mean you are currently infected or will develop related health issues. Regular follow-up with a healthcare provider is crucial for monitoring your health and addressing any concerns you may have.

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