Argentina
In Argentina the estimated number of people infected with HTLV-1/2 is not known, although there are endemic areas for both viruses. HTLV-1 is endemic in the Northwest (Jujuy and Salta Province) where the prevalence in the Kolla indigenous population is 3%. In this area, cases of ATLL and HAM/ TSP were also reported in greater numbers than in areas of low prevalence as in the rest of the country. On the other hand, HTLV-2 is endemic in indigenous communities such as Wichis and Tobas from the Chaco region (provinces of Formosa and Salta), with prevalence reaching 30%. In the rest of the country the prevalence is low with the exception of high risk groups such as, sexual workers, drug users and individuals infected with Human Immunodeficiency Virus (HIV).
HTLV remains a "forgotten" or "hidden" infection in Argentina. There is no state funding for diagnosis, except for screening provided by the National Plan of Blood at the public blood banks level, as in 2005 the detection of anti-HTLV-1/2 became mandatory in blood donors. However, HTLV is not included in any national program as it could, for example, be part of the “National Strategic Plan for HIV/AIDS, STDs and viral hepatitis” for epidemiological surveillance. Consequently, for lack of information leads to under diagnosis and the HTLV associated diseases are generally not correctly identified or suspected by health professionals. In most cases, , the individuals spend a lot of time until they have a final confirmation of the diagnosis and appropriate care and answers.
The HTLV Group of Translational Medicine, Argentina, is a reference center for HTLV since 1993. We have diagnosed 623 HTLV-1/2 cases between 1998 and 2014 (considering that we do not receive samples for confirmation from endemic areas of the country). From them, 441 were HTLV-1, 154 HTLV-2 , 22 HTLV untypeable and 6 were HTLV-1/2 coinfections.
The high rate of cases resulting in inconclusive or indeterminate serology led us to implement in 2003, a highly sensitive and specific molecular technique (the nested-PCR) that detects a virus fragment, , in order to provide a conclusive result.
During the same period, a total of 173 presumptive diagnoses of HTLV associated diseases confirmed 16 ATLL and 40 HAM/TSP in Argentine Caucasians and in individuals from other South American countries where the virus is endemic, such as Peru and Bolivia. We should bear in mind that big cities like Buenos Aires, have a high rate of resident immigrants from these countries. In addition, in most of the cases, the samples for diagnosis of the pathologies were derived from hospital services of Buenos Aires, and to a lesser extent from other non-endemic provinces like Río Negro, Santa Fe, and Tucumán. This data demonstrates that both viruses and the pathologies associated with HTLV-1 are detected sporadically but constantly in endemic areas.
It is known that both viruses are circulating in all regions and in different populations, either in low risk individuals (blood donors, pregnant women) and in high risk ones (patients with HIV, sex workers). The virus is transmitted sexually and especially by breastfeeding (preventable with compulsory prenatal screening is implemented) . The inclusion of this event in a national program to conceive surveillance strategies in order to prevent vertical and sexual transmission would significantly reduce the circulation of HTLV-1/2 in our country and spread the word for the training of health professionals. Avoiding breastfeeding by an infected woman would diminish 80% of transmissions. It would be important to train professionals for appropriate advice and implementation of reference centers with optimal diagnostic tools to provide a definitive result.
HTLV centers of Argentina
HTLV Group of Translational Medicine, Argentina provides comprehensive advice for HTLV-1/2 for every individual who wants to know about it. Dr. Mirna Biglione and Dr. Carolina Berini , are both researchers and teaching assistants at the University of Buenos Aires. They have been working in the HTLV-1/2 field since 1993, providing advice to health professionals giving theoretical and practical courses, seminars and talks to physicians for the diagnosis, monitoring and treatment of diseases associated to HTLV-1 infection (gastroenterologists, hematologists, infectious disease specialists, neurologists).
HTLV group of Translational Medicine, Argentina
MD, PhD,Mirna Biglione: Professor assistant at UBA, Researcher at CONICET
Bch. Science, PhD, Carolina Berini: Professor assistant UBA, Researcher at CONICET
Find out more via email: htlvargentina@gmail.com
In Argentina the estimated number of people infected with HTLV-1/2 is not known, although there are endemic areas for both viruses. HTLV-1 is endemic in the Northwest (Jujuy and Salta Province) where the prevalence in the Kolla indigenous population is 3%. In this area, cases of ATLL and HAM/ TSP were also reported in greater numbers than in areas of low prevalence as in the rest of the country. On the other hand, HTLV-2 is endemic in indigenous communities such as Wichis and Tobas from the Chaco region (provinces of Formosa and Salta), with prevalence reaching 30%. In the rest of the country the prevalence is low with the exception of high risk groups such as, sexual workers, drug users and individuals infected with Human Immunodeficiency Virus (HIV).
HTLV remains a "forgotten" or "hidden" infection in Argentina. There is no state funding for diagnosis, except for screening provided by the National Plan of Blood at the public blood banks level, as in 2005 the detection of anti-HTLV-1/2 became mandatory in blood donors. However, HTLV is not included in any national program as it could, for example, be part of the “National Strategic Plan for HIV/AIDS, STDs and viral hepatitis” for epidemiological surveillance. Consequently, for lack of information leads to under diagnosis and the HTLV associated diseases are generally not correctly identified or suspected by health professionals. In most cases, , the individuals spend a lot of time until they have a final confirmation of the diagnosis and appropriate care and answers.
The HTLV Group of Translational Medicine, Argentina, is a reference center for HTLV since 1993. We have diagnosed 623 HTLV-1/2 cases between 1998 and 2014 (considering that we do not receive samples for confirmation from endemic areas of the country). From them, 441 were HTLV-1, 154 HTLV-2 , 22 HTLV untypeable and 6 were HTLV-1/2 coinfections.
The high rate of cases resulting in inconclusive or indeterminate serology led us to implement in 2003, a highly sensitive and specific molecular technique (the nested-PCR) that detects a virus fragment, , in order to provide a conclusive result.
During the same period, a total of 173 presumptive diagnoses of HTLV associated diseases confirmed 16 ATLL and 40 HAM/TSP in Argentine Caucasians and in individuals from other South American countries where the virus is endemic, such as Peru and Bolivia. We should bear in mind that big cities like Buenos Aires, have a high rate of resident immigrants from these countries. In addition, in most of the cases, the samples for diagnosis of the pathologies were derived from hospital services of Buenos Aires, and to a lesser extent from other non-endemic provinces like Río Negro, Santa Fe, and Tucumán. This data demonstrates that both viruses and the pathologies associated with HTLV-1 are detected sporadically but constantly in endemic areas.
It is known that both viruses are circulating in all regions and in different populations, either in low risk individuals (blood donors, pregnant women) and in high risk ones (patients with HIV, sex workers). The virus is transmitted sexually and especially by breastfeeding (preventable with compulsory prenatal screening is implemented) . The inclusion of this event in a national program to conceive surveillance strategies in order to prevent vertical and sexual transmission would significantly reduce the circulation of HTLV-1/2 in our country and spread the word for the training of health professionals. Avoiding breastfeeding by an infected woman would diminish 80% of transmissions. It would be important to train professionals for appropriate advice and implementation of reference centers with optimal diagnostic tools to provide a definitive result.
HTLV centers of Argentina
HTLV Group of Translational Medicine, Argentina provides comprehensive advice for HTLV-1/2 for every individual who wants to know about it. Dr. Mirna Biglione and Dr. Carolina Berini , are both researchers and teaching assistants at the University of Buenos Aires. They have been working in the HTLV-1/2 field since 1993, providing advice to health professionals giving theoretical and practical courses, seminars and talks to physicians for the diagnosis, monitoring and treatment of diseases associated to HTLV-1 infection (gastroenterologists, hematologists, infectious disease specialists, neurologists).
HTLV group of Translational Medicine, Argentina
MD, PhD,Mirna Biglione: Professor assistant at UBA, Researcher at CONICET
Bch. Science, PhD, Carolina Berini: Professor assistant UBA, Researcher at CONICET
Find out more via email: htlvargentina@gmail.com