HTLV-1/2 infection in Brazilian pregnant women

Abstract

HTLV-1/2 are retroviruses with three modes of transmission: sexual, blood borne and from mother to child / vertical (VT). In endemic areas VT plays the major role in the chain of transmission, mainly by breastfeeding. Infection is lifelong and 90% of the patients are asymptomatic carriers. However, there are associations to a range of inflammatory conditions, from nonspecific dermatitis to severe diseases with poor prognosis such as adult T-cell leukemia/lymphoma (ATL) and HTLV-1associated myelopathy/tropical spastic paraparesis (HAM/TSP). So far there is no efficient prevention or treatment of HTLV-1/2 infection or the diseases caused by it. Data on HTLV-1/2 on Brazilian pregnant women is still scarce and isolated because most articles study blood donors, the infection is not notifiable and screening is not part of the antenatal routine recommended by the Ministry of Health. The goal of the present work is to gather the knowledge available on the subject in international literature.There are still no published studies about the prevalence of HTLV-1/2 infection in pregnant women in our State, however the project “Study of the prevalence and vertical transmission of HIV, HTLV and SYPHILIS in pregnant women on the metropolitan area of Rio de Janeiro” carried out by UERJ professors and funded by FAPERJ, identified a prevalence of 0.66% in women admitted for delivery on the metropolitan area of Rio de Janeiro. Based on this result, the inclusion of HTLV screening in the routine antenatal care of HUPE/UERJ was proposed.Better knowledge about the prevalence of HTLV-1/2 in pregnant women among the diverse Brazilian regions is crucial to guide the development of educational, social and public health policies to increase awareness about the condition and reduce mother to child transmission rates.