{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T23:51:53Z","timestamp":1790466713769,"version":"4.1.0"},"reference-count":39,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2011,8,2]],"date-time":"2011-08-02T00:00:00Z","timestamp":1312243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Human T-lymphotropic virus type I (HTLV-I) infects an estimated 15\u201320 million persons worldwide. A number of diseases have been associated with the virus including adult T-cell leukemia (ATL), HTLV-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP), HTLV-I uveitis, and HTLV-I-associated infective dermatitis. Once it was shown that there is an increased risk for developing HAM\/TSP associated with blood transfusion, screening for HTLV-1 among blood banks was implemented in Japan, United States, France, and the Netherlands. This process includes detection by an enzyme immunoassay (EIA) followed by a confirmatory Western blot (WB) in which recombinant proteins specific for HTLV-I Env glycoproteins are incorporated into WB strips. HTLV-I seropositive results are defined by the presence of antibodies against either gp46 or gp62\/68 (both Env protein bands) and either p19, p24, or p53 (one of the gag bands). HTLV-II seropositivity is confirmed by the presence of rgp46-II. However, numerous cases have been documented in which serum samples are reactive by EIA, but an incomplete banding pattern is displayed by subsequent confirmatory WB. Although the significance of these HTLV-I\/II seroindeterminates is unclear, it may suggest a much higher incidence of exposure to HTLV-I\/II than previously estimated.<\/jats:p>","DOI":"10.3390\/v3081320","type":"journal-article","created":{"date-parts":[[2011,8,30]],"date-time":"2011-08-30T05:41:28Z","timestamp":1314682888000},"page":"1320-1331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Prevalence and Significance of HTLV-I\/II Seroindeterminate Western Blot Patterns"],"prefix":"10.3390","volume":"3","author":[{"given":"Anna","family":"Abrams","sequence":"first","affiliation":[{"name":"Neuroimmunology Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimi","family":"Akahata","sequence":"additional","affiliation":[{"name":"Neuroimmunology Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Neuroimmunology Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD 20892, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2011,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1742-4690-2-17","article-title":"The discovery of the first human retrovirus: HTLV-1 and HTLV-2","volume":"2","author":"Gallo","year":"2005","journal-title":"Retrovirology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6058","DOI":"10.1038\/sj.onc.1208968","article-title":"Global epidemiology of HTLV-I infection and associated diseases","volume":"24","author":"Proietti","year":"2005","journal-title":"Oncogene"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/1742-4690-2-16","article-title":"Discovery of adult T-cell leukemia","volume":"2","author":"Takatsuki","year":"2005","journal-title":"Retrovirology"},{"key":"ref_4","first-page":"197","article-title":"Human T-cell leukemia virus specific antigens","volume":"15","author":"Lee","year":"1984","journal-title":"Princess Takamatsu Symp."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1182\/blood.V64.5.967.967","article-title":"Efficient transformation of previously activated and dividing T lymphocytes by human T cell leukemia-lymphoma virus","volume":"64","author":"Merl","year":"1984","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0272-2712(18)30698-X","article-title":"Clinical and molecular parameters of HTLV-I infection","volume":"8","author":"Ehrlich","year":"1988","journal-title":"Clin. Lab. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/BF01644443","article-title":"Western blot technique in the serological evaluation of three LAV\/HTLV III-infected Italian families","volume":"14","author":"Geroldi","year":"1986","journal-title":"Infection"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/BF02013400","article-title":"Detection of anti-HTLV-III\/LAV antibody by enzyme-linked immunosorbent assay in high-risk individuals in Switzerland 1974\u20131985","volume":"4","author":"Stroun","year":"1985","journal-title":"Eur. J. Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/1742-4690-5-96","article-title":"Anti-HTLV antibody profiling reveals an antibody signature for HTLV-I-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP)","volume":"5","author":"Burbelo","year":"2008","journal-title":"Retrovirology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0140-6736(86)91636-3","article-title":"Blood transfusion and HTLV-I associated myelopathy","volume":"2","author":"Osame","year":"1986","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/ana.410280110","article-title":"Nationwide survey of HTLV-I-associated myelopathy in Japan: association with blood transfusion","volume":"28","author":"Osame","year":"1990","journal-title":"Ann. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1086\/314923","article-title":"HTLV-I\/II seroindeterminate Western blot reactivity in a cohort of patients with neurological disease","volume":"180","author":"Soldan","year":"1999","journal-title":"J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3239","DOI":"10.1128\/jcm.33.12.3239-3244.1995","article-title":"Enhanced specificity of truncated transmembrane protein for serologic confirmation of human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infections by western blot (immunoblot) assay containing recombinant envelope glycoproteins","volume":"33","author":"Varma","year":"1995","journal-title":"J. Clin. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1038\/nature09442","article-title":"Origin of the human malaria parasite Plasmodium falciparum in gorillas","volume":"467","author":"Liu","year":"2010","journal-title":"Nature"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1128\/JCM.39.4.1247-1253.2001","article-title":"Serological, epidemiological, and molecular differences between human T-cell lymphotropic virus Type 1 (HTLV-1)-seropositive healthy carriers and persons with HTLV-I Gag indeterminate Western blot patterns from the Caribbean","volume":"39","author":"Rouet","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_16","first-page":"400","article-title":"Indeterminate HTLV serologic results in U.S. blood donors: Are they due to HTLV-I or HTLV-II?","volume":"5","author":"Khabbaz","year":"1992","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1089\/aid.2010.0017","article-title":"Molecular analysis of human T cell lymphotropic virus type 1 and 2 (HTLV-1\/2) seroindeterminate blood donors from Northeast Iran: Evidence of proviral tax, env, and gag sequences","volume":"27","author":"Zanjani","year":"2011","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF02982654","article-title":"Seroindeterminate HTLV-1 prevalence and characteristics in blood donors in Taiwan","volume":"77","author":"Lu","year":"2003","journal-title":"Int. J. Hematol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jcv.2008.12.015","article-title":"Molecular evidence of human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) infections in HTLV seroindeterminate individuals from Sao Paulo, Brazil","volume":"44","author":"Costa","year":"2009","journal-title":"J. Clin. Virol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1046\/j.1537-2995.2000.40040443.x","article-title":"Absence of evidence of infection with divergent primate T-lymphotropic viruses in United States blood donors who have seroindeterminate HTLV test results","volume":"40","author":"Busch","year":"2000","journal-title":"Transfusion"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/jmv.1890440119","article-title":"HTLV-I\/II infection in a high viral endemic area of Zaire, Central Africa: Comparative evaluation of serology, PCR, and significance of indeterminate western blot pattern","volume":"44","author":"Garin","year":"1994","journal-title":"J. Med. Virol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1128\/JVI.74.5.2178-2185.2000","article-title":"Characterization and sequencing of prototypic human T-lymphotropic virus type 1 (HTLV-1) from an HTLV-1\/2 seroindeterminate patient","volume":"74","author":"Waziri","year":"2000","journal-title":"J. Virol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jcv.2008.01.017","article-title":"Serological patterns and temporal trends of HTLV-1\/2 infection in high-risk populations attending Public Health Units in Sao Paulo, Brazil","volume":"42","author":"Jacob","year":"2008","journal-title":"J. Clin. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/jmv.20172","article-title":"Human T lymphotropic virus types I and II proviral sequences in Argentinian blood donors with indeterminate Western blot patterns","volume":"74","author":"Mangano","year":"2004","journal-title":"J. Med. Virol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/infdis\/163.2.257","article-title":"Antibodies to human T lymphotropic virus type I in a population from the Philippines: Evidence for cross-reactivity with Plasmodium falciparum","volume":"163","author":"Hayes","year":"1991","journal-title":"J. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1128\/cdli.1.1.5-10.1994","article-title":"Immunologic cross-reactivity between structural proteins of human T-cell lymphotropic virus type I and the blood stage of Plasmodium falciparum","volume":"1","author":"Lal","year":"1994","journal-title":"Clin. Diagn. Lab. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1002\/jmv.20460","article-title":"False positive antibody results against human T-cell lymphotropic virus in patients with severe acute respiratory syndrome","volume":"77","author":"Tsao","year":"2005","journal-title":"J. Med. Virol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/(SICI)1096-9071(199705)52:1<1::AID-JMV1>3.0.CO;2-8","article-title":"Use of a generic polymerase chain reaction assay detecting human T-lymphotropic virus (HTLV) types I, II and divergent simian strains in the evaluation of individuals with indeterminate HTLV serology","volume":"52","author":"Vandamme","year":"1997","journal-title":"J. Med. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1086\/514071","article-title":"Demographic, ethnic, and geographic differences between human T cell lymphotropic virus (HTLV) type I-seropositive carriers and persons with HTLV-I Gag-indeterminate Western blots in Central Africa","volume":"176","author":"Mauclere","year":"1997","journal-title":"J. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1073\/pnas.89.5.1939","article-title":"Human T-cell lymphotropic virus (HTLV)-related endogenous sequence, HRES-1, encodes a 28-kDa protein: A possible autoantigen for HTLV-I gag-reactive autoantibodies","volume":"89","author":"Banki","year":"1992","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1586\/eri.09.97","article-title":"Discovery and significance of new human T-lymphotropic viruses: HTLV-3 and HTLV-4","volume":"7","author":"Bagossi","year":"2009","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.patbio.2008.02.015","article-title":"The human HTLV-3 and HTLV-4 retroviruses: New members of the HTLV family","volume":"57","author":"Mahieux","year":"2009","journal-title":"Pathol. Biol. (Paris)"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1086\/499273","article-title":"Human T lymphotropic virus types I and II western blot seroindeterminate status and its association with exposure to prototype HTLV-I","volume":"193","author":"Yao","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2593","DOI":"10.1128\/JCM.41.6.2593-2595.2003","article-title":"Prevalence of human T-lymphotropic virus type 1 among blood donors from Mashhad, Iran","volume":"41","author":"Abbaszadegan","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/BF02982070","article-title":"Seroprevalence and demographic characteristics of HTLV-I among blood donors in Taiwan: 1996\u20131999","volume":"74","author":"Lu","year":"2001","journal-title":"Int. J. Hematol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1182\/blood.V80.2.544.544","article-title":"Failure to detect evidence of human T-lymphotropic virus (HTLV) type I and type II in blood donors with isolated gag antibodies to HTLV-I\/II","volume":"80","author":"Lal","year":"1992","journal-title":"Blood"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1002\/jmv.21881","article-title":"Long-term serological follow-up of blood donors with an HTLV-indeterminate western blot: Antibody profile of seroconverters and individuals with false reactions","volume":"82","author":"Martins","year":"2010","journal-title":"J. Med. Virol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0732-8893(97)00236-8","article-title":"Sensitivity of two enzyme-linked immunosorbent assay tests in relation to western blot in detecting human T-cell lymphotropic virus types I and II infection among HIV-1 infected patients from Sao Paulo, Brazil","volume":"30","author":"Meleiro","year":"1998","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/0928-0197(96)00232-2","article-title":"Sensitivity and specificity of a DNA polymerase chain reaction nonisotopic-based detection method for the confirmation of infection with human T-lymphotropic virus types I and II","volume":"6","author":"Dezzutti","year":"1996","journal-title":"Clin. Diagn. Virol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/3\/8\/1320\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:17:20Z","timestamp":1770290240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/3\/8\/1320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,2]]},"references-count":39,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2011,8]]}},"alternative-id":["v3081320"],"URL":"https:\/\/doi.org\/10.3390\/v3081320","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,2]]}}}