Low-cost and simple PCR process for access to molecular diagnosis of HTLV-1/2 in low-resource countries

Acta Trop. 2024 Dec:260:107395. doi: 10.1016/j.actatropica.2024.107395. Epub 2024 Sep 14.

Abstract

Background: HTLV-1/2 exhibit a widespread distribution globally and are associated with severe clinical manifestations, necessitating precise viral identification for diagnosis. Currently, there are no official diagnostic guidelines, and a variety of published protocols exists. We introduce an enhanced nested real-time PCR technique followed by high-resolution melting (rtPCR-HRM), designed to offer a cost-effective and straightforward tool for the simultaneous identification of both viruses.

Methods: The technique was tested in a retrospective, blinded study, involving a total panel of 110 samples, of which 47 were positive for HTLV-1, 12 for HTLV-2, and 51 tested negatives. Additionally, we compared the performance of this technique with a line immunoassay (LIA).

Results: The results demonstrate 100 % sensitivity, specificity, and diagnostic accuracy for both viruses. Sensitivity analysis indicated that at least 1 viral copy of HTLV-1 and 14.4 viral copies of HTLV-2 could be reliably detected.

Conclusions: Our results indicate that rtPCR-HRM is effective in confirming HTLV-1 and HTLV-2 infection, important in Latin American countries where both viruses circulate. Furthermore, the proposed strategy provides a new tool that can be used to resolve indeterminate cases identified by Western blot, with the added advantage of being faster and simpler than n-PCR and more cost-effective than other probe-based RT-PCRs.

Keywords: HTLV-1/2; Molecular diagnosis; health care; real-time PCR.

Publication types

  • Evaluation Study

MeSH terms

  • Developing Countries
  • HTLV-I Infections* / diagnosis
  • HTLV-I Infections* / virology
  • HTLV-II Infections* / diagnosis
  • Human T-lymphotropic virus 1* / genetics
  • Human T-lymphotropic virus 1* / isolation & purification
  • Human T-lymphotropic virus 2* / genetics
  • Human T-lymphotropic virus 2* / isolation & purification
  • Humans
  • Molecular Diagnostic Techniques* / economics
  • Molecular Diagnostic Techniques* / methods
  • Polymerase Chain Reaction / economics
  • Polymerase Chain Reaction / methods
  • Real-Time Polymerase Chain Reaction / economics
  • Real-Time Polymerase Chain Reaction / methods
  • Retrospective Studies
  • Sensitivity and Specificity*