ArticleMicrobiology spectrum2026
High prevalence of HTLV-1 among blood donors in southeastern Gabon (Central Africa): a major challenge for transfusion safety in a semi-rural area.
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Abstract
Sub-Saharan Africa is an endemic region for human T-lymphotropic virus type 1 (HTLV-1). While high prevalence rates have been reported across Gabon, systematic screening of blood donors has not yet been implemented at the national level. A cross-sectional study was conducted on 2,375 blood donations from 2,303 blood donors at the Amissa Bongo Teaching Hospital Center in Franceville. Serological screening was performed via ELISA, followed by Western Blot confirmation and PCR-based proviral DNA amplification of the IMPORTANCE: Human T-lymphotropic virus type 1 (HTLV-1) remains a major public health problem in Central Africa, with Gabon being a major endemic hotspot. This study addresses a critical issue for blood safety in semi-rural areas, where prevalence in the general adult rural population is exceptionally high, ranging from 7.3% to 8.7% according to previous studies. Here, we report a prevalence of 1.8% among blood donors in southeastern Gabon, a rate 2.5 times higher than that of blood donors in the capital. Moreover, a history of transfusion was identified as the only significant risk factor associated with HTLV-1 infection, directly demonstrating active iatrogenic transmission in the absence of systematic screening. Furthermore, the discovery of the rare HTLV-1d subtype highlights the persistent potential risk of zoonotic and human-to-human transmission in these forest-adjacent ecosystems. These results provide compelling evidence for the urgent integration of HTLV-1 screening in endemic rural areas of Gabon.
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