Fundação Hemominas, Minas Gerais, Brazil.
Pediatr Infect Dis J. 2012 Nov;31(11):1139-43. doi: 10.1097/INF.0b013e318263215e.
Human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) causes serious diseases and is endemic in many parts of the world. It is transmitted from mother to child in 15-25% of the cases, primarily through breastfeeding. Proviral load and duration of breastfeeding are thought to play a role in transmission. This study aimed to detect HTLV-seropositive mothers through testing of neonates, to evaluate maternal HTLV proviral load and to measure the rates of transmission blocking when interruption of breastfeeding was implemented.
Neonates were screened for HTLV-1/2 IgG by enzyme immunoassay using the neonatal screening program of Minas Gerais State, Brazil. Breastfeeding interruption was recommended to those whose mothers were confirmed HTLV-positive. Children were tested by polymerase chain reaction at birth and at 12 months of age.
Of 55,293 neonates tested, 42 (0.076%) were positive for HTLV-1 or HTLV-2 IgG. All 42 were polymerase chain reaction-negative at birth and 1 of 37 (2.7%) became antibody-positive after 12 months. His mother had delivered him vaginally and was informed of the positive HTLV-1 polymerase chain reaction after 7 days of breastfeeding. The mother's proviral load was 271 copies/10,000 cells, whereas the average is 109.2 copies/10,000 cells (95% confidence interval: 70.56-147.83).
Maternal HTLV-1 proviral load and the route of delivery may have played a role in the transmission observed. Avoidance of breastfeeding was an effective measure to reduce HTLV transmission. In endemic countries, routine prenatal or neonatal screening combined with formula feeding for mothers confirmed HTLV-positive may be an important strategy to prevent future development of illnesses related to HTLV.
人类 T 细胞嗜淋巴细胞病毒 1 型和 2 型（HTLV-1/2）可导致严重疾病，在世界许多地区呈地方性流行。在 15-25%的病例中，它通过母婴传播，主要通过母乳喂养。前病毒载量和母乳喂养时间被认为在传播中起作用。本研究旨在通过对新生儿进行检测来发现 HTLV 阳性母亲，评估母亲的 HTLV 前病毒载量，并在中断母乳喂养时测量阻断传播的比率。
采用巴西米纳斯吉拉斯州新生儿筛查计划，使用酶联免疫吸附试验对新生儿进行 HTLV-1/2 IgG 检测。对母亲确认为 HTLV 阳性的新生儿建议中断母乳喂养。对出生时和 12 个月时的儿童进行聚合酶链反应检测。
在 55293 名接受检测的新生儿中，有 42 名（0.076%）HTLV-1 或 HTLV-2 IgG 阳性。所有 42 名新生儿出生时聚合酶链反应均为阴性，其中 37 名中有 1 名（2.7%）在 12 个月后抗体转为阳性。他的母亲经阴道分娩，在母乳喂养 7 天后被告知其 HTLV-1 聚合酶链反应阳性。母亲的前病毒载量为 271 拷贝/10000 个细胞，而平均值为 109.2 拷贝/10000 个细胞（95%置信区间：70.56-147.83）。
母亲的 HTLV-1 前病毒载量和分娩方式可能在观察到的传播中起作用。避免母乳喂养是减少 HTLV 传播的有效措施。在流行地区，对 HTLV 阳性母亲进行常规产前或新生儿筛查，并结合配方奶喂养，可能是预防与 HTLV 相关疾病未来发生的重要策略。
