Global overview and regional protocols for molecular diagnosis of human T-cell lymphotropic virus
File(s)
Accepted version
Author(s)
Rowan, Aileen
Type
Journal Article
Abstract
Human T-cell lymphotropic virus type-1 (HTLV-1) has been recognized as an infection of global importance by WHO in their published HIV, Hepatitis and STI Global Health Sector Strategy 2022-2030, however there are no commercial molecular assays for HTLV-1 available globally. While some countries are strengthening their efforts to diagnose HTLV-1 and prevent transmission (i.e. Brazil introduced universal antenatal screening in 2024),
the prevalence of HTLV-1 in many parts of the world is unknown. Unsurprisingly, there is great inequity in access to molecular HTLV testing services which can importantly
contribute both as part of a diagnostic confirmatory testing algorithm and be used to monitor disease. Due to the lack of commercially available molecular assays, laboratories rely on in-house developed protocols, resulting in substantial variability in methodologies
and access to testing. An HTLV Testing Working Group was established by the International Retrovirology
Association in 2023 with the objective to improve access to and the quality of molecular testing for HTLV-1 globally. Representatives from nine laboratories in Argentina, Australia, Brazil, Iran, Japan, Sweden and the United Kingdom have collaboratively compared their in-house molecular protocols. The methods are presented and summarized with discussion of the relative strengths and limitations of each platform and key considerations
for laboratories establishing molecular HTLV testing capacity. This analysis provides a practical framework supporting equitable expansion of HTLV molecular diagnostics globally aiming to help countries with varying access to funding to be able to select the assay best suited to their means while recognizing the relative risks and benefits.
the prevalence of HTLV-1 in many parts of the world is unknown. Unsurprisingly, there is great inequity in access to molecular HTLV testing services which can importantly
contribute both as part of a diagnostic confirmatory testing algorithm and be used to monitor disease. Due to the lack of commercially available molecular assays, laboratories rely on in-house developed protocols, resulting in substantial variability in methodologies
and access to testing. An HTLV Testing Working Group was established by the International Retrovirology
Association in 2023 with the objective to improve access to and the quality of molecular testing for HTLV-1 globally. Representatives from nine laboratories in Argentina, Australia, Brazil, Iran, Japan, Sweden and the United Kingdom have collaboratively compared their in-house molecular protocols. The methods are presented and summarized with discussion of the relative strengths and limitations of each platform and key considerations
for laboratories establishing molecular HTLV testing capacity. This analysis provides a practical framework supporting equitable expansion of HTLV molecular diagnostics globally aiming to help countries with varying access to funding to be able to select the assay best suited to their means while recognizing the relative risks and benefits.
Date Acceptance
2026-07-02
Citation
Journal of Clinical Microbiology
ISSN
0095-1137
Publisher
American Society for Microbiology
Journal / Book Title
Journal of Clinical Microbiology
Copyright Statement
Copyright This paper is embargoed until publication. Once published the author’s accepted manuscript will be made available under a CC-BY License in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy).
License URL
Publication Status
Accepted