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Prates G, Paiva A, Haziot ME, Fonseca LAM, Smid J, Marcusso RMDN, Assone T, de Oliveira ACP, Casseb J. Could Cesarean Delivery Help Prevent Mother-to-Child Transmission of Human T-Lymphotropic Virus Type 1? J Infect Dis 2023; 228:1766-1775. [PMID: 37386934 DOI: 10.1093/infdis/jiad219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/09/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Mother-to-child transmission (MTCT) of human T-lymphotropic virus type 1 (HTLV-1) is an important route of transmission that can cause lifelong infection. There is high morbidity and mortality due to adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy (HAM), and other inflammatory disorders. These conditions develop in nearly 10% of people with HTLV-1 infection, with a higher risk if infection occurs early in life. Identification of risk factors can inform targeted measures to reduce HTLV-1 MTCT. This study aimed to investigate the potential of cesarean delivery to prevent HTLV-1 MTCT. METHODS We performed a review of the cases of women and their offspring under regular follow-up at the HTLV-1 outpatient clinic at the Institute of Infectious Diseases Emilio Ribas. RESULTS A total of 177 HTLV-1-infected women and 369 adult offspring were investigated. Overall, 15% of the children were positive for HTLV-1 and 85% were negative. Regarding vertical transmission, we found that a breastfeeding duration of >6 months was associated with MTCT. Moreover, maternal proviral load was not associated with transmission, but high educational level and cesarean delivery were identified as protective factors. CONCLUSIONS HTLV-1 MTCT was associated with mother's age at delivery of >25 years, low educational level, prolonged breastfeeding, and vaginal delivery.
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Affiliation(s)
- Gabriela Prates
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Arthur Paiva
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Universitary Hospital of the Federal University of Alagoas, Maceió, Brazil
| | - Michel E Haziot
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | - Luiz Augusto M Fonseca
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | | | - Tatiane Assone
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Jorge Casseb
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Francese R, Peila C, Donalisio M, Lamberti C, Cirrincione S, Colombi N, Tonetto P, Cavallarin L, Bertino E, Moro GE, Coscia A, Lembo D. Viruses and Human Milk: Transmission or Protection? Adv Nutr 2023; 14:1389-1415. [PMID: 37604306 PMCID: PMC10721544 DOI: 10.1016/j.advnut.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
Human milk (HM) is considered the best source of nutrition for infant growth and health. This nourishment is unique and changes constantly during lactation to adapt to the physiological needs of the developing infant. It is also recognized as a potential route of transmission of some viral pathogens although the presence of a virus in HM rarely leads to a disease in an infant. This intriguing paradox can be explained by considering the intrinsic antiviral properties of HM. In this comprehensive and schematically presented review, we have described what viruses have been detected in HM so far and what their potential transmission risk through breastfeeding is. We have provided a description of all the antiviral compounds of HM, along with an analysis of their demonstrated and hypothesized mechanisms of action. Finally, we have also analyzed the impact of HM pasteurization and storage methods on the detection and transmission of viruses, and on the antiviral compounds of HM. We have highlighted that there is currently a deep knowledge on the potential transmission of viral pathogens through breastfeeding and on the antiviral properties of HM. The current evidence suggests that, in most cases, it is unnecessarily to deprive an infant of this high-quality nourishment and that the continuation of breastfeeding is in the best interest of the infant and the mother.
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Affiliation(s)
- Rachele Francese
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Chiara Peila
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Manuela Donalisio
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Cristina Lamberti
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Simona Cirrincione
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Nicoletta Colombi
- Biblioteca Federata di Medicina "Ferdinando Rossi", University of Turin, Turin, Italy
| | - Paola Tonetto
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Laura Cavallarin
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Enrico Bertino
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Guido E Moro
- Italian Association of Human Milk Banks (AIBLUD), Milan, Italy.
| | - Alessandra Coscia
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy.
| | - David Lembo
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy.
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Uchimaru K, Itabashi K. Measures for the Prevention of Mother-to-Child Human T-Cell Leukemia Virus Type 1 Transmission in Japan: The Burdens of HTLV-1-Infected Mothers. Viruses 2023; 15:2002. [PMID: 37896779 PMCID: PMC10610977 DOI: 10.3390/v15102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
The main mode of mother-to-child transmission of the human T-cell leukemia virus (HTLV)-1 is through breastfeeding. Although the most reliable nutritional regimen to prevent HTLV-1 transmission is exclusive formula feeding, a recent meta-analysis revealed that short-term breastfeeding within 90 days does not increase the risk of infection. The protocol of the Japanese Health, Labor, and Welfare Science Research Group primarily recommended exclusive formula feeding for mothers who are positive for HTLV-1. However, there has been no quantitative research on the difficulties experienced by HTLV-1-positive mothers in carrying out these nutritional regimens, including the psychological burden. Therefore, this review was performed to clarify the burdens and difficulties encountered by mothers who are positive for HTLV-1; to this end, we analyzed the data registrants on the HTLV-1 career registration website "Carri-net" website. The data strongly suggest that it is not sufficient to simply recommend exclusive formula feeding or short-term breastfeeding as a means of preventing mother-to-child transmission; it is important for health care providers to understand that these nutritional regimens represent a major burden for pregnant women who are positive for HTLV-1 and to provide close support to ensure these women's health.
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Affiliation(s)
- Kaoru Uchimaru
- Department of Tumor Cell Biology, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 1088639, Japan
| | - Kazuo Itabashi
- Aiseikai-Memorial Ibaraki Welfare and Medical Center, Ibaraki 3100836, Japan;
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Diakite M, Shaw-Saliba K, Lau CY. Malignancy and viral infections in Sub-Saharan Africa: A review. FRONTIERS IN VIROLOGY (LAUSANNE, SWITZERLAND) 2023; 3:1103737. [PMID: 37476029 PMCID: PMC10358275 DOI: 10.3389/fviro.2023.1103737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The burden of malignancy related to viral infection is increasing in Sub-Saharan Africa (SSA). In 2018, approximately 2 million new cancer cases worldwide were attributable to infection. Prevention or treatment of these infections could reduce cancer cases by 23% in less developed regions and about 7% in developed regions. Contemporaneous increases in longevity and changes in lifestyle have contributed to the cancer burden in SSA. African hospitals are reporting more cases of cancer related to infection (e.g., cervical cancer in women and stomach and liver cancer in men). SSA populations also have elevated underlying prevalence of viral infections compared to other regions. Of 10 infectious agents identified as carcinogenic by the International Agency for Research on Cancer, six are viruses: hepatitis B and C viruses (HBV and HCV, respectively), Epstein-Barr virus (EBV), high-risk types of human papillomavirus (HPV), Human T-cell lymphotropic virus type 1 (HTLV-1), and Kaposi's sarcoma herpesvirus (KSHV, also known as human herpesvirus type 8, HHV-8). Human immunodeficiency virus type 1 (HIV) also facilitates oncogenesis. EBV is associated with lymphomas and nasopharyngeal carcinoma; HBV and HCV are associated with hepatocellular carcinoma; KSHV causes Kaposi's sarcoma; HTLV-1 causes T-cell leukemia and lymphoma; HPV causes carcinoma of the oropharynx and anogenital squamous cell cancer. HIV-1, for which SSA has the greatest global burden, has been linked to increasing risk of malignancy through immunologic dysregulation and clonal hematopoiesis. Public health approaches to prevent infection, such as vaccination, safer injection techniques, screening of blood products, antimicrobial treatments and safer sexual practices could reduce the burden of cancer in Africa. In SSA, inequalities in access to cancer screening and treatment are exacerbated by the perception of cancer as taboo. National level cancer registries, new screening strategies for detection of viral infection and public health messaging should be prioritized in SSA's battle against malignancy. In this review, we discuss the impact of carcinogenic viruses in SSA with a focus on regional epidemiology.
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Affiliation(s)
- Mahamadou Diakite
- University Clinical Research Center, University of Sciences, Techniques, and Technologies, Bamako, Mali
| | - Kathryn Shaw-Saliba
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Chuen-Yen Lau
- HIV Dynamics and Replication Program, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, United States
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Current Interventions to Prevent HTLV-1 Mother-to-Child Transmission and Their Effectiveness: A Systematic Review and Meta-Analysis. Microorganisms 2022; 10:microorganisms10112227. [PMID: 36363819 PMCID: PMC9694434 DOI: 10.3390/microorganisms10112227] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
Human T lymphotropic virus 1 (HTLV-1) may be transmitted from mother to child and affects at least 5−10 million individuals worldwide, with severe consequences on health. Strategies to prevent transmission are important, as there is no treatment or vaccine. This systematic review aimed to identify interventions to prevent HTLV-1 mother-to-child transmission and to determine their effectiveness. Exclusive formula feeding, short-term breastfeeding, use of freeze−thaw milk, milk pasteurization, maternal and infant antiretroviral drugs, caesarean section, early clamping of umbilical cord, screening of milk donors and avoidance of cross-breastfeeding were identified as possible strategies. Avoidance of breastfeeding is an intervention that prevents 85% of transmissions. This strategy is recommended in Japan, Brazil, Colombia, Canada, Chile, Uruguay, the USA and some regions of French Guyana. Whilst breastfeeding for <3 months does not increase the risk of transmission compared to exclusive formula-feeding, concerns remain regarding the limited number of studies outside Japan, and the lack of information on women having higher risk of HTLV-1 transmission and on the ability of women to discontinue breastfeeding. Additional interventions are plausible, but data on their effectiveness are limited. The acceptance of interventions is high. These findings may guide healthcare professionals and support policymakers in implementing policies to avoid HTLV-1 mother-to-child transmission.
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Itabashi K, Miyazawa T. Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention. Cancers (Basel) 2021; 13:cancers13164100. [PMID: 34439253 PMCID: PMC8394315 DOI: 10.3390/cancers13164100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/29/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 95% of mother-to-child transmission (MTCT) of human T-cell leukemia virus type-1 (HTLV-1) is derived from prolonged breastfeeding, which is a major cause of adult T-cell leukemia (ATL). Exclusive formula feeding (ExFF) is therefore generally used to prevent MTCT. A recent cohort study revealed that 55% of pregnant carriers chose short-term breastfeeding for ≤3 months in Japan. Our meta-analysis showed that there was no significant increase in the risk of MTCT when breastfeeding was carried out for ≤3 months compared with ExFF (pooled relative risk (RR), 0.72; 95% confidence interval (CI), 0.30-1.77), but there was an almost threefold increase in risk when breastfeeding was carried out for up to 6 months (pooled RR, 2.91; 95% CI, 1.69-5.03). Thus, short-term breastfeeding for ≤3 months may be useful in preventing MTCT. Breastmilk is the best nutritional source for infants, and any approach to minimizing MTCT by avoiding or limiting breastfeeding must be balanced against the impact on the child's health and mother-child bonding. To minimize the need for nutritional interventions, it is necessary to identify factors that predispose children born to carrier mothers to MTCT and thereby predict MTCT development with a high degree of accuracy.
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Affiliation(s)
- Kazuo Itabashi
- Aiseikai Memorial Ibaraki Welfare Medical Center, 1872-1 Motoyoshida-cho, Mito-City 310-0836, Japan
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
- Correspondence: ; Tel.: +81-29-353-7171; Fax: +81-29-353-6112
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
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Desgraupes S, Hubert M, Gessain A, Ceccaldi PE, Vidy A. Mother-to-Child Transmission of Arboviruses during Breastfeeding: From Epidemiology to Cellular Mechanisms. Viruses 2021; 13:1312. [PMID: 34372518 PMCID: PMC8310101 DOI: 10.3390/v13071312] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 12/20/2022] Open
Abstract
Most viruses use several entry sites and modes of transmission to infect their host (parenteral, sexual, respiratory, oro-fecal, transplacental, transcutaneous, etc.). Some of them are known to be essentially transmitted via arthropod bites (mosquitoes, ticks, phlebotomes, sandflies, etc.), and are thus named arthropod-borne viruses, or arboviruses. During the last decades, several arboviruses have emerged or re-emerged in different countries in the form of notable outbreaks, resulting in a growing interest from scientific and medical communities as well as an increase in epidemiological studies. These studies have highlighted the existence of other modes of transmission. Among them, mother-to-child transmission (MTCT) during breastfeeding was highlighted for the vaccine strain of yellow fever virus (YFV) and Zika virus (ZIKV), and suggested for other arboviruses such as Chikungunya virus (CHIKV), dengue virus (DENV), and West Nile virus (WNV). In this review, we summarize all epidemiological and clinical clues that suggest the existence of breastfeeding as a neglected route for MTCT of arboviruses and we decipher some of the mechanisms that chronologically occur during MTCT via breastfeeding by focusing on ZIKV transmission process.
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Affiliation(s)
- Sophie Desgraupes
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Mathieu Hubert
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Antoine Gessain
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Pierre-Emmanuel Ceccaldi
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Aurore Vidy
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
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Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru. Pathogens 2021; 10:pathogens10030260. [PMID: 33668710 PMCID: PMC7996293 DOI: 10.3390/pathogens10030260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 01/13/2023] Open
Abstract
Background. Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2) Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. (3) Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.
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Human T-cell Leukemia Virus Type 1 and Strongyloides stercoralis: Partners in Pathogenesis. Pathogens 2020; 9:pathogens9110904. [PMID: 33137906 PMCID: PMC7692131 DOI: 10.3390/pathogens9110904] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/07/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
Infection with human T-cell leukemia/lymphoma virus type 1 (HTLV-1) has been associated with various clinical syndromes including co-infection with Strongyloides stercoralis, which is an intestinal parasitic nematode and the leading cause of strongyloidiasis in humans. Interestingly, HTLV-1 endemic areas coincide with regions citing high prevalence of S. stercoralis infection, making these communities optimal for elucidating the pathogenesis of co-infection and its clinical significance. HTLV-1 co-infection with S. stercoralis has been observed for decades in a number of published patient cases and case series; however, the implications of this co-infection remain elusive. Thus far, data suggest that S. stercoralis increases proviral load in patients co-infected with HTLV-1 compared to HTLV-1 infection alone. Furthermore, co-infection with HTLV-1 has been associated with shifting the immune response from Th2 to Th1, affecting the ability of the immune system to address the helminth infection. Thus, despite this well-known association, further research is required to fully elucidate the impact of each pathogen on disease manifestations in co-infected patients. This review provides an analytical view of studies that have evaluated the variation within HTLV-1 patients in susceptibility to S. stercoralis infection, as well as the effects of strongyloidiasis on HTLV-1 pathogenesis. Further, it provides a compilation of available clinical reports on the epidemiology and pathology of HTLV-1 with parasitic co-infection as well as data from mechanistic studies suggesting possible immunopathogenic mechanisms. Furthermore, specific areas of potential future research have been highlighted to facilitate advancing understanding of the complex interactions between these two pathogens.
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Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis. Pathogens 2020; 9:pathogens9060450. [PMID: 32517313 PMCID: PMC7350296 DOI: 10.3390/pathogens9060450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity.
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11
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Rosadas C, Taylor GP. Mother-to-Child HTLV-1 Transmission: Unmet Research Needs. Front Microbiol 2019; 10:999. [PMID: 31134031 PMCID: PMC6517543 DOI: 10.3389/fmicb.2019.00999] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/18/2019] [Indexed: 02/04/2023] Open
Abstract
Mother-to-child transmission (MTCT) of Human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection. At least 5–10 million individuals worldwide are currently living with HTLV-1. Studies of regional variation are required to better understand the contribution of MTCT to the global burden of infection. Although most infected individuals remain asymptomatic ∼10% develop high morbidity, high mortality disease. Infection early in life is associated with a higher risk of disease development. Adult T-cell leukemia (ATL), which is caused by HTLV-1 and has a median survival of 8 months is linked to MTCT, indeed evidence of ATL following infection as an adult is sparse. Infective dermatitis also only occurs following neonatal infection. Whilst HTLV-1-associated myelopathy (HAM) follows sexual and iatrogenic infection approximately 30% of patients presenting with HAM/TSP acquired the infection through their mothers. HAM/TSP is a disabling neurodegenerative disease that greatly impact patient’s quality of life. To date there is no cure for HTLV-1 infection other than bone marrow transplantation for ATL nor any measure to prevent HTLV-1 associated diseases in an infected individual. In this context, prevention of MTCT is expected to contribute disproportionately to reducing both the incidence of HTLV-1 and the burden of HTLV-1 associated diseases. In order to successfully avoid HTLV-1 MTCT, it is important to understand all the variables involved in this route of infection. Questions remain regarding frequency and risk factors for in utero peri-partum transmission whilst little is known about the efficacy of pre-labor cesarean section to reduce these infections. Understanding the contribution of peripartum infection to the burden of disease will be important to gauge the risk-benefit of interventions in this area. Few studies have examined the impact of HTLV-1 infection on fertility or pregnancy outcomes nor the susceptibility of the mother to infection during pregnancy and lactation. Whilst breast-feeding is strongly associated with transmission and avoidance of breast-feeding a proven intervention little is known about the mechanism of transmission from the breast milk to the infant and there have been no clinical trials of antiretroviral therapy (ARV) to prevent this route of transmission.
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Affiliation(s)
- Carolina Rosadas
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
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12
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Akinboyo IC, Crane GM, Chen L, Arav-Boger R. A 17-Year-Old Boy With Right Face Palsy, Left Leg Weakness, and Lytic Skull-Bone Lesions. J Pediatric Infect Dis Soc 2018; 7:350-354. [PMID: 29373673 PMCID: PMC6276027 DOI: 10.1093/jpids/pix101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/18/2017] [Indexed: 11/13/2022]
Abstract
Human T-cell lymphotropic virus (HTLV), an infection that is endemic in certain parts of Asia, Africa, and South America, has been associated with malignancy and neurological deficits. Here, we describe a pediatric patient with chronic HTLV-I infection who developed complications associated with HTLV-I (ie, adult T-cell leukemia/lymphoma and HTLV-I-associated myelopathy/tropical spastic paraparesis). To our knowledge, this presentation in a child has never been described. The patient underwent a bone marrow transplant and, at the time of this writing, was in remission. This case report highlights the fact that HTLV-related complications, previously expected to occur after decades of infection, also can occur in pediatric patients, particularly those who acquired HTLV-I perinatally.
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Affiliation(s)
- Ibukunoluwa C Akinboyo
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland,Correspondence: I. C. Akinboyo, 200 N Wolfe St., Room 3155, Baltimore, MD 21287 ()
| | - Genevieve M Crane
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lingling Chen
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ravit Arav-Boger
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Hamada T, Nomura H, Iwatsuki K. Regional incidences of adult T-cell leukemia/lymphoma with cutaneous involvement in Japan. J Dermatol 2017; 45:58-63. [DOI: 10.1111/1346-8138.14100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/18/2017] [Indexed: 01/30/2023]
Affiliation(s)
- Toshihisa Hamada
- Departments of Dermatology; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
- The Japanese Study Group for Cutaneous Lymphomas; The Japanese Skin Cancer Society; Kumamoto Japan
| | - Hayato Nomura
- Departments of Dermatology; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - Keiji Iwatsuki
- Departments of Dermatology; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
- The Japanese Study Group for Cutaneous Lymphomas; The Japanese Skin Cancer Society; Kumamoto Japan
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Abstract
: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.
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Mother-to-Child Transmission of HTLV-1 Epidemiological Aspects, Mechanisms and Determinants of Mother-to-Child Transmission. Viruses 2016; 8:v8020040. [PMID: 26848683 PMCID: PMC4776195 DOI: 10.3390/v8020040] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/22/2016] [Accepted: 01/27/2016] [Indexed: 12/20/2022] Open
Abstract
Human T-cell Lymphotropic Virus type 1 (HTLV-1) is a human retrovirus that infects at least 5-10 million people worldwide, and is the etiological agent of a lymphoproliferative malignancy; Adult T-cell Leukemia/Lymphoma (ATLL); and a chronic neuromyelopathy, HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP), as well as other inflammatory diseases such as infective dermatitis and uveitis. Besides sexual intercourse and intravenous transmission, HTLV-1 can also be transmitted from infected mother to child during prolonged breastfeeding. Some characteristics that are linked to mother-to-child transmission (MTCT) of HTLV-1, such as the role of proviral load, antibody titer of the infected mother, and duration of breastfeeding, have been elucidated; however, most of the mechanisms underlying HTLV-1 transmission during breast feeding remain largely unknown, such as the sites of infection and cellular targets as well as the role of milk factors. The present review focuses on the latest findings and current opinions and perspectives on MTCT of HTLV-1.
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Sobata R, Matsumoto C, Uchida S, Suzuki Y, Satake M, Tadokoro K. Estimation of the infectious viral load required for transfusion-transmitted human T-lymphotropic virus type 1 infection (TT-HTLV-1) and of the effectiveness of leukocyte reduction in preventing TT-HTLV-1. Vox Sang 2015; 109:122-8. [PMID: 25930000 DOI: 10.1111/vox.12263] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND OBJECTIVES The risk of transfusion-transmitted human T-lymphotropic virus type 1 infection (TT-HTLV-1) after prestorage leucocyte reduction (LR) remains unknown, as the proviral load in the blood component that would cause TT-HTLV-1 is undetermined. On the basis of the distribution of HTLV-1 proviral load among HTLV-1-sero-positive blood donors, we attempted to estimate the proviral load for transfusion-related infectivity. We also discuss the effectiveness of LR in preventing TT-HTLV-1. MATERIALS AND METHODS The HTLV-1 proviral load in 300 HTLV-1-sero-positive blood donors was determined by real-time polymerase chain reaction analysis. The proviral load required for transfusion-related infectivity was estimated using historical TT-HTLV-1 frequency data from a retrospective study on patients who had received blood from HTLV-1-sero-positive blood donors and the distribution pattern of HTLV-1 proviral load among blood donors. RESULTS HTLV-1 proviral loads ranged between < 0.01 and 25.0 copies per 100 leucocytes. Historical data showed TT-HTLV-1 frequency to be 80%. Assuming that 80% of the 300 sero-positive samples are infectious, it is estimated that the transfer of ≥ 9 × 10(4) cells containing the HTLV-1 provirus is required to establish TT-HTLV-1. CONCLUSION The residual number of HTLV-1-infected cells after LR is substantially lower than the viral load necessary for TT-HTLV-1. LR therefore appears to be effective in minimizing the incidence of TT-HTLV-1.
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Affiliation(s)
- R Sobata
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - C Matsumoto
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - S Uchida
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Y Suzuki
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - M Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - K Tadokoro
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
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Gogarten JF, Akoua-Koffi C, Calvignac-Spencer S, Leendertz SAJ, Weiss S, Couacy-Hymann E, Koné I, Peeters M, Wittig RM, Boesch C, Hahn BH, Leendertz FH. The ecology of primate retroviruses - an assessment of 12 years of retroviral studies in the Taï national park area, Côte d׳Ivoire. Virology 2014; 460-461:147-53. [PMID: 25010280 DOI: 10.1016/j.virol.2014.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 03/24/2014] [Accepted: 05/09/2014] [Indexed: 01/10/2023]
Abstract
The existence and genetic make-up of most primate retroviruses was revealed by studies of bushmeat and fecal samples from unhabituated primate communities. For these, detailed data on intra- and within-species contact rates are generally missing, which makes identification of factors influencing transmission a challenging task. Here we present an assessment of 12 years of research on primate retroviruses in the Taï National Park area, Côte d'Ivoire. We discuss insights gained into the prevalence, within- and cross-species transmission of primate retroviruses (including towards local human populations) and the importance of virus-host interactions in determining cross-species transmission risk. Finally we discuss how retroviruses ecology and evolution may change in a shifting environment and identify avenues for future research.
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Affiliation(s)
- Jan F Gogarten
- Research group Epidemiology of Highly Pathogenic Microorganisms RKI, Berlin, Germany; Primatology department, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany; Department of Biology, McGill University, Montreal, Quebec, Canada
| | - Chantal Akoua-Koffi
- Reseach Center for the Development and Teaching Hospital, Université Alassane Ouattara de Bouake, Cote d׳Ivoire
| | | | - Siv Aina J Leendertz
- Research group Epidemiology of Highly Pathogenic Microorganisms RKI, Berlin, Germany
| | - Sabrina Weiss
- Research group Epidemiology of Highly Pathogenic Microorganisms RKI, Berlin, Germany
| | | | - Inza Koné
- Taï Monkey Project, Centre Suisse de Recherches Scientifiques, B.P. 1303 Abidjan, Côte d'Ivoire and Laboratory of Zoology, University of Cocody, 22 B.P. 582, Abidjan 22, Côte d׳Ivoire
| | - Martine Peeters
- UMI 233, TransVIHMI, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
| | - Roman M Wittig
- Primatology department, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Christophe Boesch
- Primatology department, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Beatrice H Hahn
- Department of Microbiology and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Fabian H Leendertz
- Research group Epidemiology of Highly Pathogenic Microorganisms RKI, Berlin, Germany.
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Ita F, Mayer EF, Verdonck K, Gonzalez E, Clark D, Gotuzzo E. Human T-lymphotropic virus type 1 infection is frequent in rural communities of the southern Andes of Peru. Int J Infect Dis 2013; 19:46-52. [PMID: 24262672 DOI: 10.1016/j.ijid.2013.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate the presence of human T-lymphotropic virus type 1 (HTLV-1) infection in isolated rural communities in the southern Andes of Peru. METHODS We conducted a cross-sectional study in five communities located in three provinces in Ayacucho, Peru. The five communities are located at >3000 meters above sea level and are mainly rural, and more than 85% of the population speaks Quechua. Volunteers aged 12 years and older were included. Clinical and epidemiological data were collected, along with a blood sample for serological testing. RESULTS We included 397 participants; their median age was 41 years (interquartile range 31-57 years) and 69% were women. According to our definitions, 98% were of Quechua origin. HTLV-1 was diagnosed in 11 people: 0/164 in Cangallo, 3/154 (2%) in Vilcashuaman, and 8/79 (10%) in Parinacochas. There were no cases of HTLV-2. All the HTLV-1-positive participants were born in Ayacucho and were of Quechua origin; they ranged in age from 29 to 87 years (median 56 years) and 10/11 were women. Ten were apparently healthy, and one woman was diagnosed with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Three out of 11 had a family member with a lower limb impairment compatible with HAM/TSP. CONCLUSION The fact that HTLV-1 infection was present in two out of three provinces suggests that HTLV-1 could be highly endemic in the southern Andes in the Quechua population.
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Affiliation(s)
- Fanny Ita
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Erick F Mayer
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kristien Verdonck
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Institute of Tropical Medicine, Antwerp, Belgium
| | - Elsa Gonzalez
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Clark
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorios de Investigación y Desarrollo (LID), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Cayetano Heredia, Lima, Peru
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Inflammatory, vascular, and infectious myelopathies in children. HANDBOOK OF CLINICAL NEUROLOGY 2013; 112:999-1017. [PMID: 23622308 DOI: 10.1016/b978-0-444-52910-7.00020-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Acute nontraumatic myelopathies of childhood include inflammatory, infectious, and vascular etiologies. Inflammatory immune-mediated disorders of the spinal cord can be categorized as idiopathic isolated transverse myelitis, neuromyelitis optica, and multiple sclerosis. In recent years, human T-cell lymphotropic virus type 1, West Nile virus, enterovirus-71, and Lyme disease have been increasingly recognized as infectious etiologies of myelopathy, and poliomyelitis remains an important etiology in world regions where vaccination programs have not been universally available. Vascular etiologies include vasculopathies (systemic lupus erythematosus, small vessel primary angiitis of the central nervous system), arteriovenous malformations, and spinal cord infarction (fibrocartilaginous embolism, diffuse hypoxic ischemia-mediated infarction). Vascular myelopathies are less common than inflammatory and infectious myelopathies, but are more likely to lead to devastating clinical deficits. Current therapeutic strategies include acute anti-inflammatory treatment and rehabilitation. Stem cell transplantation, nerve graft implantation, and stimulation of endogenous repair mechanisms represent promising strategies for spinal cord repair.
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Breastfeeding and transmission of viruses other than HIV-1. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 743:27-38. [PMID: 22454339 DOI: 10.1007/978-1-4614-2251-8_2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Treviño A, Benito R, Caballero E, Ramos JM, Parra P, Roc L, Eiros JM, Aguilera A, García J, Cifuentes C, Marcaida G, Rodríguez C, Trigo M, Arroyo LA, de Mendoza C, de Lejarazu RO, Soriano V. HTLV infection among foreign pregnant women living in Spain. J Clin Virol 2011; 52:119-22. [PMID: 21782504 DOI: 10.1016/j.jcv.2011.06.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 05/23/2011] [Accepted: 06/24/2011] [Indexed: 12/25/2022]
Abstract
BACKGROUND The overall seroprevalence of HTLV infection among pregnant women in Spain is below 0.02% and accordingly universal antenatal screening is not recommended. However, as the number of immigrants has significantly increased during the last decade, this population might warrant specific considerations. OBJECTIVE To evaluate the seroprevalence of HTLV infection among immigrant pregnant women living in Spain. METHODS From January 2009 to December 2010 a cross-sectional study was carried out in all foreign pregnant women attended at 14 Spanish clinics. All were tested for HTLV antibodies using a commercial enzyme-immunoassay, being reactive samples confirmed by Western blot or PCR. RESULTS A total of 3337 foreign pregnant women were examined. Their origin was as follows: Latin America 1579 (47%), North Africa 507 (16%), East Europe 606 (18%), Sub-Saharan Africa 316 (9%), North America and West Europe 116 (3.5%) and Asia and Australia 163 (5%). A total of 7 samples were confirmed as HTLV positive, of which 6 were HTLV-1 and 1 HTLV-2. HTLV-1 infection was found in 5 women coming from Latin America and 1 from Morocco. The only woman with HTLV-2 came from Ghana. The overall HTLV seroprevalence was 0.2%, being 0.3% among Latin Americans and 0.2% among Africans. It was absent among women coming from other regions. CONCLUSIONS The seroprevalence of HTLV infection among foreign pregnant women in Spain is 0.2%, being all cases found in immigrants from Latin America and Africa. Given the benefit of preventing vertical transmission, antenatal screening should be recommended in pregnant women coming from these regions.
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Affiliation(s)
- Ana Treviño
- Infectious Diseases Department, Hospital Carlos III, Calle Sinesio Delgado 10, Madrid, Spain.
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Hino S. Establishment of the milk-borne transmission as a key factor for the peculiar endemicity of human T-lymphotropic virus type 1 (HTLV-1): the ATL Prevention Program Nagasaki. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2011; 87:152-66. [PMID: 21558754 PMCID: PMC3149377 DOI: 10.2183/pjab.87.152] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 02/24/2011] [Indexed: 05/13/2023]
Abstract
In late 2010, the nation-wide screening of pregnant women for human T-lymphotropic virus type 1 (HTLV-1) infection was implemented in Japan to prevent milk-borne transmission of HTLV-1. In the late 1970s, recognition of the adult T-cell leukemia (ATL) cluster in Kyushu, Japan, led to the discovery of the first human retrovirus, HTLV-1. In 1980, we started to investigate mother-to-child transmission (MTCT) for explaining the peculiar endemicity of HTLV-1. Retrospective and prospective epidemiological data revealed the MTCT rate at ∼20%. Cell-mediated transmission of HTLV-1 without prenatal infection suggested a possibility of milk-borne transmission. Common marmosets were successfully infected by oral inoculation of HTLV-1 harboring cells. A prefecture-wide intervention study to refrain from breast-feeding by carrier mothers, the ATL Prevention Program Nagasaki, was commenced in July 1987. It revealed a marked reduction of HTLV-1 MTCT by complete bottle-feeding from 20.3% to 2.5%, and a significantly higher risk of short-term breast-feeding (<6 months) than bottle-feeding (7.4% vs. 2.5%, P < 0.001).
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Trends in HTLV-1 prevalence and incidence of adult T-cell leukemia/lymphoma in Nagasaki, Japan. J Med Virol 2010; 82:668-74. [DOI: 10.1002/jmv.21738] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Treviño A, Aguilera A, Caballero E, Toro C, Eiros JM, de Lejarazu RO, Rodríguez-Calviño JJ, Tuset C, Gómez-Hernando C, Rodríguez-Iglesias M, Ramos JM, Rodríguez-Díaz JC, Benito R, Trigo M, García-Campello M, Calderón E, Garcia J, Rodríguez C, Soriano V. Seroprevalence of HTLV-1/2 infection among native and immigrant pregnant women in Spain. AIDS Res Hum Retroviruses 2009; 25:551-4. [PMID: 19544594 DOI: 10.1089/aid.2008.0268] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
HTLV-1=2 antenatal screening is not mandatory in European countries. The rapid increase in immigrants coming from areas endemic for HTLV-1 infection has compelled a review of this policy in Spain. From February 2006 to December 2007, a cross-sectional study was carried out in all pregnant women attended at 10 different Spanish hospitals. An enzyme immunoassay (EIA) was used to test serum HTLV-1=2 antibodies; reactive samples were further confirmed by Western blot and=or polymerase chain reaction. A total of 20,518 pregnant women were examined, of whom 18,266 (89%) were native Spaniards. Overall, 946 (4.6%) of the immigrants came from HTLV-1 endemic areas (mainly Central and South America and sub-Saharan Africa). Four samples were EIA seroreactive for HTLV-1=2, two of them in women infected with HTLV-1 coming from endemic areas. The other two women were infected with HTLV-2; one was an immigrant from Bolivia and another was a native Spaniard who admitted prior injection drug use and was HIV-1 positive. The overall HTLV-1=2 seroprevalence was 0.19 per 1000 (95% CI: 0.05-0.49=1000). For HTLV-1, the seroprevalence was 2.11 per 1000 (95% CI: 0.26-7.62=1000) in pregnant women from endemic areas. The seroprevalence of HTLV-1=2 infection is below 0.02% among pregnant women in Spain, and therefore universal screening for HTLV-1=2 infection in antenatal clinics is not warranted. However, HTLV-1=2 screening could be considered in pregnant women coming from endemic areas, in whom the rate of infection is nearly 1000-fold higher than in native Spaniards and are the only group infected with the more pathogenic HTLV-1.
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Affiliation(s)
- Ana Treviño
- Department of Infectious Diseases, Hospital Carlos III, Madrid
| | - Antonio Aguilera
- Department of Microbiology, Hospital Conxo, Santiago de Compostela, Spain
| | | | - Carlos Toro
- Department of Infectious Diseases, Hospital Carlos III, Madrid
| | - José M. Eiros
- Department of Microbiology, Hospital Clínico Universitario, Valladolid, Spain
| | | | | | - Concepción Tuset
- Department of Immunology, Hospital General Universitario, Valencia, Spain
| | - César Gómez-Hernando
- Department of Microbiology, Complejo Hospitalario Virgen de la Salud, Toledo, Spain
| | | | | | | | - Rafael Benito
- Department of Microbiology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Matilde Trigo
- Department of Microbiology, Complejo Hospitalario, Pontevedra, Spain
| | | | - Enrique Calderón
- CIBER in Epidemiology and Public Health Hospital Universitario Virgen del Rocio Seville, Spain
| | - Juan Garcia
- Department of Microbiology, Hospital Cristal-Piñor, Orense, Spain
| | | | - Vincent Soriano
- Department of Infectious Diseases, Hospital Carlos III, Madrid
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Dal Fabbro MMFJ, Cunha RVD, Bóia MN, Portela P, Botelho CA, Freitas GMBD, Soares J, Ferri J, Lupion J. [HTLV 1/2 infection: prenatal performance as a disease control strategy in State of Mato Grosso do Sul]. Rev Soc Bras Med Trop 2008; 41:148-51. [PMID: 18545834 DOI: 10.1590/s0037-86822008000200003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 04/07/2008] [Indexed: 11/22/2022] Open
Abstract
In this study, the prevalence of HTLV 1/2 infection among pregnant women in the State of Mato Grosso do Sul was estimated by means of the ELISA, Western Blot and PCR techniques, in blood samples collected by peripheral venous puncture. 116,689 pregnant women were examined and 153 were diagnosed as presenting HTLV 1/2 infection, with prevalence of 0.13%. Among these 153 pregnant women, 133 (86.9%) had type 1 and 20 (11.1%) had type 2; 73.2% were black, brown or indigenous; about 90% performed domestic activities; and 75.8% (116/153) had been to school for seven years or less. The 153 pregnant women had 172 pregnancies during the study period and 164 pregnancies were followed. Out of pregnancies that were followed, 6.7% (11/164) evolved to abortion, 26.8% (41/153) reported previous abortions and 31.7% (13/41) had had more than two abortions. Comorbidities were found in 17% (26/153), among whom 3.3% (5/153) had HIV (p<0.000002). The authors emphasize the importance of identifying pregnant women with HTLV 1/2 infection, as a strategy for disease control and prevention.
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Hieshima K, Nagakubo D, Nakayama T, Shirakawa AK, Jin Z, Yoshie O. Tax-inducible production of CC chemokine ligand 22 by human T cell leukemia virus type 1 (HTLV-1)-infected T cells promotes preferential transmission of HTLV-1 to CCR4-expressing CD4+ T cells. THE JOURNAL OF IMMUNOLOGY 2008; 180:931-9. [PMID: 18178833 DOI: 10.4049/jimmunol.180.2.931] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Adult T cell leukemia is a mature CD4+ T cell malignancy which predominantly expresses CCR4 and is etiologically associated with human T cell leukemia virus type 1 (HTLV-1). Because HTLV-1 transmission depends on close cell-cell contacts, HTLV-1-infected T cells may preferentially interact with CCR4+CD4+ T cells for efficient viral transmission. In terms of gene expression and protein secretion, we found a strong correlation between HTLV-1 Tax oncoprotein and CCL22, a CCR4 ligand, in HTLV-1-infected T cells. Transient Tax expression in an HTLV-1-negative T cell line activated the CCL22 promoter and induced CCL22. Additionally, tax gene knockdown by small interference RNA reduced CCL22 expression in the infected T cells. These findings indicate that CCL22 is a cellular target gene of Tax. In chemotaxis assays, the culture supernatants of HTLV-1-infected T cells selectively attracted CCR4+CD4+ T cells in PBMCs. This was blocked by pretreating the supernatants with anti-CCL22 Ab or PBMCs with a synthetic CCR4 antagonist. In coculture experiments, primary CCR4+CD4+ T cells significantly adhered to Tax-expressing cells. This adhesion was blocked by the CCR4 antagonist or pertussis toxin. Interestingly, CCR4 was redistributed to the contact region, and in some cases, this was accompanied by a polarized microtubule-organizing center, which is an indicator of virological synapse formation, in the infected T cells. Finally, anti-CCL22 Ab treatment also blocked HTLV-1 transmission to primary CD4+ T cells in coculture experiments with HTLV-1 producer cells. Thus, HTLV-1-infected T cells produce CCL22 through Tax and selectively interact with CCR4+CD4+ T cells, resulting in preferential transmission of HTLV-1 to CCR4+CD4+ T cells.
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Affiliation(s)
- Kunio Hieshima
- Department of Microbiology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
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Bittencourt AL, Barbosa HS, Requião C, da Silva AC, Vandamme AM, Van Weyenbergh J, Farré L. Adult T-Cell Leukemia/Lymphoma With a Mixed CD4+ and CD8+ Phenotype and Indolent Course. J Clin Oncol 2007; 25:2480-2. [PMID: 17557960 DOI: 10.1200/jco.2007.11.3043] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Achiléa L Bittencourt
- Department of Pathology, Hospital Universitário Prof Edgard Santos, Federal University of Bahia, Brazil
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Komori K, Hasegawa A, Kurihara K, Honda T, Yokozeki H, Masuda T, Kannagi M. Reduction of human T-cell leukemia virus type 1 (HTLV-1) proviral loads in rats orally infected with HTLV-1 by reimmunization with HTLV-1-infected cells. J Virol 2006; 80:7375-81. [PMID: 16840318 PMCID: PMC1563733 DOI: 10.1128/jvi.00230-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) persistently infects humans, and the proviral loads that persist in vivo vary widely among individuals. Elevation in the proviral load is associated with serious HTLV-1-mediated diseases, such as adult T-cell leukemia and HTLV-1-associated myelopathy/tropical spastic paraparesis. However, it remains controversial whether HTLV-1-specific T-cell immunity can control HTLV-1 in vivo. We previously reported that orally HTLV-1-infected rats showed insufficient HTLV-1-specific T-cell immunity that coincided with elevated levels of the HTLV-1 proviral load. In the present study, we found that individual HTLV-1 proviral loads established in low-responding hosts could be reduced by the restoration of HTLV-1-specific T-cell responses. Despite the T-cell unresponsiveness for HTLV-1 in orally infected rats, an allogeneic mixed lymphocyte reaction in the splenocytes and a contact hypersensitivity response in the skin of these rats were comparable with those of naive rats. HTLV-1-specific T-cell response in orally HTLV-1-infected rats could be restored by subcutaneous reimmunization with mitomycin C (MMC)-treated syngeneic HTLV-1-transformed cells. The reimmunized rats exhibited lower proviral loads than untreated orally infected rats. We also confirmed that the proviral loads in orally infected rats decreased after reimmunization in the same hosts. Similar T-cell immune conversion could be reproduced in orally HTLV-1-infected rats by subcutaneous inoculation with MMC-treated primary T cells from syngeneic orally HTLV-1-infected rats. The present results indicate that, although HTLV-1-specific T-cell unresponsiveness is an underlying risk factor for the propagation of HTLV-1-infected cells in vivo, the risk may potentially be reduced by reimmunization, for which autologous HTLV-1-infected cells are a candidate immunogen.
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Affiliation(s)
- Kazuya Komori
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Atsuhiko Hasegawa
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Kiyoshi Kurihara
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Takayuki Honda
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Hiroo Yokozeki
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Takao Masuda
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
| | - Mari Kannagi
- Department of Immunotherapeutics, Department of Dermatology, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan, Division of Immunology, Tulane National Primate Research Center, Tulane, Louisiana 70433
- Corresponding author. Mailing address: Department of Immunotherapeutics, Faculty of Medicine, Tokyo Medical and Dental University, Medical Research Division, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Phone: 81-3-5803-5798. Fax: 81-3-5803-0235. E-mail:
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Armah HB, Narter-Olaga EG, Adjei AA, Asomaning K, Gyasi RK, Tettey Y. Seroprevalence of human T-cell lymphotropic virus type I among pregnant women in Accra, Ghana. J Med Microbiol 2006; 55:765-770. [PMID: 16687597 DOI: 10.1099/jmm.0.46426-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Infection with human T-cell lymphotropic virus type I (HTLV-I) occurs mainly in Japan, Central and West Africa and the Caribbean Basin. Although antibody to HTLV-I has been reported among pregnant women in several endemic countries, there is no information regarding the seroprevalence in pregnant Ghanaian women. The reported seroprevalence of HTLV-I among healthy Ghanaian blood donors is between 0.5 and 4.2 %. Therefore, this study was conducted to determine the seroprevalence of HTLV-I among pregnant women attending the antenatal clinic at the 37 Military Hospital, Accra, Ghana, between the months of January and December 2003. The presence of antibodies specific for HTLV-I/II was tested using a particle agglutination test (PAT) kit and confirmed by Western blotting (WB). Of the 960 sera tested, HTLV-I/II antibodies were detected in 24 samples using the PAT kit. WB results indicated that, of the 24 positive PAT specimens, 20 specimens (83.3 %) were HTLV-I positive, one (4.2 %) was HTLV-II positive, two (8.3 %) were HTLV positive and one (4.2 %) was indeterminate. Therefore, the overall seroprevalence of HTLV-I was 2.1 %. Seroprevalence increased with age, suggesting sexual contact as the primary mode of transmission among women of childbearing age, rather than breastfeeding during infancy. The seroprevalence of 2.1 % reported here for HTLV-I in pregnant women in Accra is comparable to that of human immunodeficiency virus among the same population. In conclusion, the results indicate that HTLV-I is prevalent among asymptomatic Ghanaian pregnant women and thus there is a need to consider introducing antenatal screening for HTLV-I in Ghana.
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Affiliation(s)
- Henry B Armah
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Hugh Gloster Building (BMSB) Room 350, 720 Westview Drive SW, Atlanta, GA 30310-1495, USA
| | - Edwin G Narter-Olaga
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Andrew A Adjei
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Kofi Asomaning
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Richard K Gyasi
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Yao Tettey
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
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Kibler KV, Jeang KT. Human T-cell leukemia virus type I: 25 years of progress and challenges. J Biomed Sci 2005; 12:7-11. [PMID: 15864735 DOI: 10.1007/s11373-004-8164-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Accepted: 12/24/2004] [Indexed: 10/25/2022] Open
Affiliation(s)
- Karen V Kibler
- Center for Infectious Diseases and Vaccinology, Arizona State University, Tempe, AZ 85287, USA
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Abstract
Three viruses (CMV, HIV, and HTLV-I) frequently cause infection or disease as a result of breast-milk transmission. Reasonable guidelines have been pro-posed for when and how to avoid breast milk in the case of maternal infection. For other viruses, prophylactic immune therapy to protect the infant against all modes of transmission are indicated (VZV, varicella-zoster immunoglobulin, HAV and immunoglobulin, HBV, and HBIg + HBV vaccine). In most maternal viral infections, breast milk is not an important mode of transmission, and continuation of breastfeeding is in the best interest of the infant and mother (see Tables 2 and 3). Maternal bacterial infections rarely are complicated by transmission of infection to their infants through breast milk. In a few situations, temporary cessation of breastfeeding or the avoidance of breast milk is appropriate for a limited time (24 hours for N gonorrheae, H infiuenzae, Group B streptococci, and staphylococci and longer for others including B burgdorferi, T pallidum, and M tuberculosis). In certain situations, prophylactic or empiric therapy may be advised for the infant (eg, T pallidum, M tuberculosis, H influenzae) (see Table 1). Antimicrobial use by the mother should not be a reason not to breastfeed. Alternative regimens that are compatible with breastfeeding can be chosen to treat the mother effectively. In most cases of suspected infection in the breastfeeding mother, the delay in seeking medical care and making the diagnosis means the infant has been ex-posed already. Stopping breastfeeding at this time only deprives the infant of the nutritional and potential immunologic benefits. Breastfeeding or the use of expressed breast milk, even if temporarily suspended, should be encouraged and supported. Decisions about breast milk and infection should balance the potential risk compared with the innumerable benefits of breast milk.
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Affiliation(s)
- Robert M Lawrence
- Division of Pediatric Immunology and Infectious Diseases, University of Florida College of Medicine, Health Science Center, Gainesville, FL 32610-0296, USA.
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32
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Araújo APQC, Fontenelle LMC, Pádua PAB, Maia Filho HS, Araújo ADQC. Juvenile human T lymphotropic virus type 1-associated myelopathy. Clin Infect Dis 2002; 35:201-4. [PMID: 12087528 DOI: 10.1086/341251] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2001] [Revised: 02/25/2002] [Indexed: 11/03/2022] Open
Abstract
We report the cases of 5 adolescents with human T lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis, acquired in all but 1 case from the mother. The first symptom in all patients was difficulty in running, which was present for many years before the final diagnosis was made. Follow-up showed an indolent progression, regardless of treatment strategy.
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Affiliation(s)
- Alexandra P Q C Araújo
- Child Neurology Unit, Federal University of Rio de Janeiro, Rio de Janeiro, RJ 22640-100, Brazil.
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Bittencourt AL, Dourado I, Filho PB, Santos M, Valadão E, Alcantara LC, Galvão-Castro B. Human T-cell lymphotropic virus type 1 infection among pregnant women in northeastern Brazil. J Acquir Immune Defic Syndr 2001; 26:490-4. [PMID: 11391171 DOI: 10.1097/00126334-200104150-00016] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An evaluation of human T-cell lymphotropic virus type 1 (HTLV-1) infection among 6754 pregnant women in Salvador, Bahia, Brazil using enzyme-linked immunosorbent assay, Western blot analysis, and polymerase chain reaction assay found a rate of infection of 0.84% (57 of 6754 women). Epidemiologic and obstetric data on the HTLV-1-positive pregnant women were analyzed and compared with data on a control group of HTLV-1-negative pregnant women. The mean age of the HTLV-1-positive women was 26.2 years. All were seronegative for HIV and syphilis, and only 2 reported a past history of sexually transmitted infection and more than 10 sexual partners. Of the HTLV-1-positive women, 88.5% were breast-fed, 4% were bottle fed, and 7.5% did not know. Six women had received blood transfusions, and only 1 reported intravenous drug use. Fifty-two HTLV-1-positive women could be followed: 45 had full-term deliveries, 5 had premature deliveries, and 2 had abortions. Our results indicate that (1) the frequency of HTLV-1 infection among pregnant women is relatively high in Salvador, Bahia, Brazil; (2) maternal infection was probably acquired more frequently through breast-feeding, but the sexual route was certainly the second most important means of transmission; (3) HTLV-1-positive women had a history of eczema-like infections in childhood more frequently than the control group; (4) HTLV-1 infection did not interfere in the course of pregnancy; and (5) no associated congenital infections were observed in the HTLV-1-positive women.
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Affiliation(s)
- A L Bittencourt
- Department of Pathology and Instituto de Saúde Coletiva, School of Medicine, Federal University of Bahia, Brazil.
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Human T-Cell Lymphotropic Virus Type 1 Infection Among Pregnant Women in Northeastern Brazil. J Acquir Immune Defic Syndr 2001. [DOI: 10.1097/00042560-200104150-00016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Moriuchi M, Moriuchi H. A milk protein lactoferrin enhances human T cell leukemia virus type I and suppresses HIV-1 infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2001; 166:4231-6. [PMID: 11238676 DOI: 10.4049/jimmunol.166.6.4231] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human T cell leukemia virus type I (HTLV-I) and HIV-1, causative agents of adult T cell leukemia/lymphoma and AIDS, respectively, are transmitted vertically via breast milk. Here we demonstrate that lactoferrin, a milk protein that has a variety of antimicrobial and immunomodulatory activities, facilitates replication of HTLV-I in lymphocytes derived from asymptomatic HTLV-I carriers and transmission to cord blood lymphocytes in vitro. Transient expression assays revealed that lactoferrin can transactivate HTLV-I long terminal repeat promoter. In contrast, lactoferrin inhibits HIV-1 replication, at least in part, at the level of viral fusion/entry. These results suggest that lactoferrin may have different effects on vertical transmission of the two milk-borne retroviruses.
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Affiliation(s)
- M Moriuchi
- Division of Medical Virology, Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Medical Sciences, Japan
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Ades AE, Parker S, Walker J, Edginton M, Taylor GP, Weber JN. Human T cell leukaemia/lymphoma virus infection in pregnant women in the United Kingdom: population study. BMJ (CLINICAL RESEARCH ED.) 2000; 320:1497-501. [PMID: 10834889 PMCID: PMC27390 DOI: 10.1136/bmj.320.7248.1497] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2000] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the prevalence of human T cell leukaemia/lymphoma virus (HTLV) infection in pregnant women in the United Kingdom. DESIGN Population study. SUBJECTS Guthrie card samples from babies born in 1997-8. Samples were linked to data on mother's age and ethnic status and parents' country of birth and then anonymised. SETTING North Thames Regional Health Authority. MAIN OUTCOME MEASURES Presence of antibodies against HTLV in eluates tested by gelatin particle agglutination assay and results confirmed by immunoblot. RESULTS Of 126 010 samples tested, 67 had confirmed antibodies to HTLV (59 HTLV-I, 2 HTLV-II, 6 untyped) and six had indeterminate results. Seroprevalence was 17.0 per 1000 (95% confidence interval 9.2 to 28.3) in infants whose mothers were born in the Caribbean, 3.2/1000 (1.5 to 5.9) with mothers born in west and central Africa, and 6.8/1000 (3.1 to 12.9) in infants of black Caribbean mothers born in non-endemic regions. In infants with no known risk (both parents born in non-endemic regions and mother not black Caribbean) seroprevalence was 0.06-0.12 per 1000. Mother's country of birth, father's country of birth, and mother's ethnic status were all independently associated with neonatal seroprevalence. An estimated 223 (95% confidence interval 110 to 350) of the 720 000 pregnant women each year in the United Kingdom are infected with HTLV. CONCLUSIONS The prevalence of HTLV and HIV infections in pregnant women in the United Kingdom are comparable. The cost effectiveness of antenatal HTLV screening should be evaluated, and screening of blood donations should be considered.
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Affiliation(s)
- A E Ades
- Department of Epidemiology and Public Health, Institute of Child Health, London WC1N 1EH.
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37
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Tortevoye P, Tuppin P, Peneau C, Carles G, Gessain A. Decrease of human T-cell lymphotropic virus type I prevalence and low incidence among pregnant women from a high endemic ethnic group in French Guiana. Int J Cancer 2000. [DOI: 10.1002/1097-0215(20000815)87:4<534::aid-ijc12>3.0.co;2-m] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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38
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Ureta-Vidal A, Angelin-Duclos C, Tortevoye P, Murphy E, Lepère JF, Buigues RP, Jolly N, Joubert M, Carles G, Pouliquen JF, de Thé G, Moreau JP, Gessain A. Mother-to-child transmission of human T-cell-leukemia/lymphoma virus type I: implication of high antiviral antibody titer and high proviral load in carrier mothers. Int J Cancer 1999; 82:832-6. [PMID: 10446450 DOI: 10.1002/(sici)1097-0215(19990909)82:6<832::aid-ijc11>3.0.co;2-p] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In order to gain new insights into the risk factors influencing human-T-cell-leukemia/lymphoma-virus-type-I (HTLV-I) mother-to-child transmission, a retrospective study of HTLV-I infection among children born to HTLV-I-seropositive women was carried out in a highly HTLV-I-endemic population of African origin living in French Guyana. The study covered 81 HTLV-I-seropositive mothers and their 216 children aged between 18 months old and 12 years old. All plasma samples were tested for the presence of HTLV-I antibodies by ELISA, immunofluorescence assay and Western blot. HTLV-I provirus was detected, in the DNA extracted from peripheral-blood mononuclear cells, by polymerase chain reaction (PCR) using primers specific for 3 different HTLV-I genomic regions (LTR, gag and pX) and quantified by a competitive PCR assay. Out of the 216 children, 21 were found to be HTLV-I-seropositive, giving a crude HTLV-I transmission rate of 9.7%, while among the 180 breast-fed children 10.6% were HTLV-I-seropositive. Perfect concordance between serological and PCR results was observed, and none of the 195 HTLV-I-negative children was found HTLV-I-positive by PCR. In conditional (by family) logistic-regression models, HTLV-I seropositivity in children was associated with an elevated maternal anti-HTLV-I-antibody titer (OR 2.2, p = 0.0013), a high maternal HTLV-I proviral load (OR 2.6, p = 0.033) and child's gender, girls being more frequently HTLV-I-infected than boys: OR 3.6, p = 0.0077 in the model including maternal anti-HTLV-I-antibody titer and OR 4.1, p = 0.002 in the model including the maternal HTLV-I proviral load.
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Affiliation(s)
- A Ureta-Vidal
- Unité d'Epidémiologie des Virus Oncogènes, Institut Pasteur, Paris, France
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Guiltinan AM, Murphy EL, Horton JA, Nass CC, McEntire RL, Watanabe K. Psychological distress in blood donors notified of HTLV-I/II infection. Retrovirus Epidemiology Donor Study. Transfusion 1998; 38:1056-62. [PMID: 9838938 DOI: 10.1046/j.1537-2995.1998.38111299056317.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Blood donations in the United States have been screened for antibody to human T-cell lymphotropic virus types I and II (HTLV-I/II) since November 1988. Although clinically diagnosed illness associated with HTLV-I/II remains relatively uncommon, blood donors notified of HTLV infection frequently report negative psychological and social effects following notification. STUDY DESIGN AND METHODS To assess psychological outcomes, the General Well-Being Scale, a standardized 18-item questionnaire, was administered to 464 HTLV-I/II-positive donors and 91 sex partners at five blood centers in the United States following notification of HTLV-I/II infection. The questionnaire was also given to 735 HTLV-I/II-negative donors. RESULTS Scores for donors seropositive for HTLV-I and HTLV-II showed significantly more psychological distress than did scores for seronegative donors (p < 0.0005) or a large national sample (p < 0.05). Both HTLV-I (p = 0.02) and HTLV-II (p = 0.01) seropositivity remained significant predictors of lower overall well-being scores after analysis controlling for race, age, gender, education, income, donation type, time since notification, self-reported health status, and intravenous drug use. Variables that predicted higher overall scores were negative HTLV status, older age, higher income, better health, fewer sick days, and fewer work limitations due to health problems. CONCLUSION Increased psychological distress may be related to notification of HTLV infection among blood donors in the United States.
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Affiliation(s)
- A M Guiltinan
- Blood Centers of the Pacific, San Francisco, California
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Abstract
The vertical transmission of the human T-cell lymphotropic virus type I (HTLV-I) occurs predominantly through breast-feeding. Since some bottle-fed children born to carrier mothers still remain seropositive with a frequency that varies from 3.3% to 12.8%, an alternative pathway of vertical transmission must be considered. The prevalence rate of vertical transmission observed in Japan varied from 15% to 25% in different surveys. In Brazil there is no evaluation of this form of transmission until now. However, it is known that in Salvador, Bahia, 0.7% to 0.88% of pregnant women of low socio-economic class are HTLV-I carriers. Furthermore the occurrence of many cases of adult T-cell leukemia/lymphoma and of four cases of infective dermatitis in Salvador, diseases directly linked to the vertical transmission of HTLV-I, indicates the importance of this route of infection among us. Through prenatal screening for HTLV-I and the refraining from breast-feeding a reduction of approximately 80% of vertical transmission has been observed in Japan. We suggest that in Brazil serologic screening for HTLV-I infection must be done for selected groups in the prenatal care: pregnant women from endemic areas, Japanese immigrants or Japanese descendents, intravenous drug users (IDU) or women whose partners are IDU, Human immunodeficiency virus carriers, pregnant women with promiscuous sexual behavior and pregnant women that have received blood transfusions in areas where blood donors screening is not performed. There are in the literature few reports demonstrating the vertical transmission of HTLV-II.
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Affiliation(s)
- A L Bittencourt
- Faculdade de Medicina, Universidade Federal da Bahia, Brasil.
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41
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Agadjanyan MG, Wang B, Nyland SB, Weiner DB, Ugen KE. DNA plasmid based vaccination against the oncogenic human T cell leukemia virus type 1. Curr Top Microbiol Immunol 1998; 226:175-92. [PMID: 9479842 DOI: 10.1007/978-3-642-80475-5_11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- M G Agadjanyan
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
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Ravandi-Kashani F, Sriswasdi C, Lynott A, Giles FJ. HTLV-1 and Adult T-Cell Leukemia/Lymphoma: A Review. Hematology 1998; 3:429-41. [PMID: 27420330 DOI: 10.1080/10245332.1998.11746417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Infection with the human T-lymphotropic virus type 1 (HTLV-1) has been shown to be fundamental to the etiology of Adult T-cell Leukemia/Lymphoma (ATL). The disease is endemic in specific geographic areas but is increasingly reported from non-endemic regions. With increasing number of patients with this entity, the diversity in the clinical features has become apparent. In the past treatment strategies using combination chemotherapy have been unsatisfactory, but more recent trials using adenosine analouges, interferons, and combination of interferons and AZT have shown promise. With increased understanding of the etiology and molecular basis of the disease more effective therapies can be anticipated.
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Affiliation(s)
- F Ravandi-Kashani
- a Department of Leukemia , University of Texas , M.D. Anderson Cancer Center , Houston , Texas
| | - C Sriswasdi
- a Department of Leukemia , University of Texas , M.D. Anderson Cancer Center , Houston , Texas
| | - A Lynott
- b International Oncology Study Group , Houston , Texas
| | - F J Giles
- a Department of Leukemia , University of Texas , M.D. Anderson Cancer Center , Houston , Texas
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