[The current state and issues for HTLV-1 asymptomatic carrier management]

The number of HTLV-1 carriers is estimated using a proportion of anti-HTLV-1 antibody-positive blood donors. In Japan, approximately 820 thousand people carry HTLV-1. Strategies for the prevention of HTLV-1 infection include anti-HTLV-1 antibody screening of pregnant women and recommendation of formula feeding for mothers who are anti-HTLV-1 positive to prevent mother-to-child transmission of HTLV-1. However, mothers who cannot breastfeed grieve and mental health care for these mothers is important. The development of consulting systems for HTLV-1 carriers is also important. The development of basic institutional systems for consultation and follow-up of HTLV-1 carriers are increasing. A third important issue in HTLV-1 carrier management is the identification of high-risk carriers for ATL development. Based on registry systems, such as JSPFAD (Joint Study on Predisposing Factors of ATL Development), identification of risk factors, flow cytometric analysis, and detection of genome mutations using a target sequence technique have improved. The investigation of risk factors will reveal the mechanism of ATL development from HTLV-1 infected cells. The development of effective agents for pre-emptive and preventive therapy for ATL is expected through these research endeavors.