van Tienen Carla, McConkey Samuel J, de Silva Thushan I, Cotten Matthew, Kaye Steve, Sarge-Njie Ramu, da Costa Carlos, Gonçalves Nato, Parker Julia, Vincent Tim, Jaye Assan, Aaby Peter, Whittle Hilton, Schim van der Loeff Maarten
Viral Diseases Program, Medical Research Council, Fajara, The Gambia and Erasmus Medical Centre, Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands.
AIDS Res Hum Retroviruses. 2012 Jun;28(6):584-90. doi: 10.1089/AID.2011.0219. Epub 2012 Mar 9.
The relative importance of routes of transmission of human T cell lymphotropic virus type 1 (HTLV-1) in Guinea-Bissau is largely unknown; vertical transmission is thought to be important, but there are very few existing data. We aimed to examine factors associated with transmission in mothers and children in Guinea-Bissau, where HTLV-1 is endemic (prevalence of 5% in the adult population). A cross-sectional survey was performed among mothers and their children (aged <15 years) in a rural community in Guinea-Bissau. A questionnaire to identify risk factors for infection and a blood sample were obtained. HTLV-1 proviral load in peripheral blood was determined and PCR was performed to compare long terminal repeat (LTR) sequences in mother-child pairs. Fourteen out of 55 children (25%) of 31 HTLV-1-infected mothers were infected versus none of 70 children of 30 uninfected mothers. The only factor significantly associated with HTLV-1 infection in the child was the proviral load of the mother; the risk of infection increased significantly with the log(10) proviral load in the mother's peripheral blood (OR 5.5, 95% CI 2.1-14.6, per quartile), adjusted for weaning age and maternal income. HTLV-1 sequences of the LTR region obtained from mother-child pairs were identical within pairs but differed between the pairs. Vertical transmission plays an important role in HTLV-1 transmission in this community in Guinea-Bissau. The risk of transmission increases with the mother's proviral load in the peripheral blood. Identical sequences in mother-child pairs give additional support to the maternal source of the children's infection.
在几内亚比绍，人类嗜T细胞病毒1型（HTLV-1）传播途径的相对重要性很大程度上尚不清楚；垂直传播被认为很重要，但现有数据极少。我们旨在研究几内亚比绍母婴中与HTLV-1传播相关的因素，该国HTLV-1为地方病（成年人口患病率为5%）。在几内亚比绍一个农村社区对母亲及其15岁以下子女进行了横断面调查。获取了一份用于识别感染风险因素的问卷和一份血样。测定外周血中HTLV-1前病毒载量，并进行聚合酶链反应（PCR）以比较母婴对中的长末端重复序列（LTR）。31名HTLV-1感染母亲的55名子女中有14名（25%）被感染，而30名未感染母亲的70名子女均未感染。与儿童HTLV-1感染显著相关的唯一因素是母亲的前病毒载量；根据断奶年龄和母亲收入进行调整后，儿童感染风险随母亲外周血中前病毒载量的log(10)值显著增加（每四分位数的比值比为5.5，95%置信区间为2.1-14.6）。从母婴对中获得的LTR区域的HTLV-1序列在对中是相同的，但在不同对之间存在差异。在几内亚比绍的这个社区中，垂直传播在HTLV-1传播中起重要作用。传播风险随母亲外周血中的前病毒载量增加。母婴对中相同的序列为儿童感染的母源提供了额外支持。
