Evaluating the Prevalence of Human T-cell Lymphotropic Virus in Blood Donors and Thalassemia and Hemophilia Patients in Rafsanjan and Jiroft Cities of Kerman Province, Iran

Document Type : Research Article


1 Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman, Iran

2 Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran


Human T-cell leukemia virus (HTLV) is a member of the retroviridae family that can be transmitted through infected lymphocytes, sex, blood transfusion, and organ transplantation as well as from mother to child by breastfeeding. It is estimated that nearly 15-20 million people have been infected with the virus worldwide. HTLV can cause malignant diseases such as adult T-cell leukemia (ATL), inflammatory diseases such as uveitis, HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), alveolitis, and infectious dermatitis. Iran is considered to be the country most infected with HTLV in Asia, after Japan. This study aimed to evaluate the serological prevalence of HTLV 1/2 infection in blood donors and thalassemia major and hemophilic patients in Rafsanjan and Jiroft cities of Kerman province. Sera were collected from 100 blood donors, 60 thalassemia major patients, and six hemophilic patients and tested for the presence of HTLV1/2 specific antibody using enzyme-linked immunosorbent assay (ELISA) and confirmed with Western blot and (real-time reverse transcription polymerase chain reaction) qRT-PCR techniques. The results of the ELISA test for Rafsanjan and Jiroft blood donors, as well as thalassemia and hemophilic patients in Rafsanjan, were negative but among thalassemia major patients of Jiroft, there was one positive case.  The results of Western blot and qRT-PCR tests were also positive. The number of provirus copies was, 3140750 per ml of the sample. Based on the findings of this study, the Kerman province is important in terms of the spread of the HTLV virus. According to the identification of infection in thalassemia patients in this province, it is recommended to investigate the incidence of this infection in other high-risk populations in this region.


Andrade RG, Ribeiro MA, Namen-Lopes MSS, Silva SMN, Basques FV, Ribas JG, ..., Martins ML. 2010. Evaluation of the use of real-time PCR for human T cell lymphotropic virus 1 and 2 as a confirmatory test in screening for blood donors. Rev Soc Bras Med 43: 111-115.
Azarpazhooh MR, Hasanpour K, Ghanbari M, Rezaee SR, Mashkani B, Hedayati-Moghaddam MR, ..., Rafatpanah H. 2012. Human T-lymphotropic virus type 1 prevalence in northeastern Iran, Sabzevar: an epidemiologic-based study and phylogenetic analysis. AIDS Res Hum Retroviruses 28(9): 1095-1101.
Abedi F, Mozhgani SH, Rahimzadegan M, Gudarzi H, Valizadeh N, Rezaee SA. 2017. Prevalence and phylogenic study of human T-lymphotropic virus 1 in patients with thalassemia in the northeast of Iran. Future Virol 12(5): 253-258.
Berini CA, Delfino C, Torres O, García G, Espejo R, Pianciola L, ..., Biglione MM. 2013. HTLV-1 cosmopolitan and HTLV-2 subtype b among pregnant women of non-endemic areas of Argentina. Sex Transm Infect 89(4): 333-335.
Carneiro-Proietti AB, Amaranto-Damasio MS, Leal-Horiguchi CF, Bastos RH, Seabra-Freitas G, Borowiak DR, …, Martins ML, 2014. Mother-to-Child transmission of human T-Cell lymphotropic Viruses-1/2: what we know, and what are the gaps in understanding and preventing this route of infection. J Pediatric Infect Dis Soc 3 Suppl 1, S24-29.
Farid R, 1999. Phylogenetic of human T-cell lymphotropic virus type I in Iranians born in Mashhsd. Arch Irn Med 2: 24-25.
Gessain A, Cassar O. 2012. Epidemiological aspects and world distribution of HTLV-1 infection. Front Microbiol 3: 388. https://doi.org/10.3389/fmicb.2012.00388.
Gonçalves DU, Proietti FA, Ribas JGR, Araújo MG, Pinheiro SR, Guedes AC, …, Carneiro-Proietti ABF. 2010. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev 23(3): 577-589.
Hedayati Moghaddam MR, 2013. Seroepidemiology of human T-cell lymphotropic virus type 1 infection in Iran: An overview. J Med Counc Islam Repub Iran 30(4): 367-78.
Hedayati-Moghaddam MR, Jafarzadeh Esfehani R, El Hajj H, Bazarbachi A. 2022. Updates on the epidemiology of the human T-cell leukemia virus type 1 infection in the countries of the eastern mediterranean regional office of the world health organization with special emphasis on the situation in Iran. Viruses 14(4), 664. doi: 10.3390/v14040664.
Karimi G, Zadsar M, Pourfathollah AA. 2017. Seroprevalence and geographical distribution of human T-lymphotropic virus type 1 among volunteer blood donors in endemic areas of Iran. Virol J 14(1): 1-9.
Keshvari M, Hajibeigi B, Azarkeivan A, Keyvani H, Behnava B, Saiedi Hosseini SY, ..., Alavian SM. 2014. Seroepidemiology of human T‐cell lymphotropic virus among Iranian adult thalassemic patients. Transfus Med 24(4): 227-232.
Lairmore MD, Anupam R, Bowden N, Haines R, Haynes II RA, Ratner L, Green PL. 2011. Molecular determinants of human T-lymphotropic virus type 1 transmission and spread. Viruses 3(7): 1131-1165.
Martinez MP, Cheng X, Joseph A, Al-Saleem J, Panfil AR, Palettas M, …, Green PL, 2019. HTLV-1 CTCF-binding site is dispensable for in vitro immortalization and persistent infection in vivo. Retrovirology 16: 1-13. https://doi.org/10.1186/s12977-019-0507-9
Nagai M, Brennan MB, Sakai JA, Mora CA, Jacobson S. 2001. CD8+ T cells are an in vivo reservoir for human T-cell lymphotropic virus type I. Blood Am J Hematol 98(6): 1858-1861.
Olière S, Douville R, Sze A, Belgnaoui SM, Hiscott J. 2011. Modulation of innate immune responses during human T-cell leukemia virus (HTLV-1) pathogenesis. Cytokine Growth Factor Rev 22(4): 197-210.
Pirayeshfard L, Sharifi Z, Amini‐Kafiabad S, Haghnazari Sadaghiani N. 2018. Phylogenetic analysis of HTLV‐1 in Iranian blood donors, HIV‐1 positive patients and patients with beta thalassemia. J Med Virol 90(8): 1398-1405.
Rafatpanah H, Torkamani M, Valizadeh N, Vakili R, Meshkani B, Khademi H, ..., Rezaee SA. 2016. Prevalence and phylogenetic analysis of HTLV‐1 in a segregated population in Iran. J Med Virol 88(7): 1247-1253.
Richardson JH, Edwards AJ, Cruickshank JK, Rudge P, Dalgleish A. 1990. In vivo cellular tropism of human T-cell leukemia virus type 1. Virol J 64(11): 5682-5687.
Verdonck K, González E, Van Dooren S, Vandamme AM, Vanham G, Gotuzzo E. 2007. Human T-lymphotropic virus 1: recent knowledge about an ancient infection. Lancet Infect Dis 7(4): 266-281.