Bohiltea Roxana Elena, Turcan Natalia, Berceanu Costin, Munteanu Octavian, Georgescu Tiberiu Augustin, Ducu Ionita, Neacsu Adrian, Furtunescu Florentina
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, 050098 Bucharest, Romania.
Exp Ther Med. 2021 Jan;21(1):82. doi: 10.3892/etm.2020.9514. Epub 2020 Nov 26.
Human T-lymphotropic virus (HTLV) is considered to be the most highly oncogenic existing virus, being the cause of several fatal diseases such as adult T cell leukemia-lymphoma (ATL) and HTLV-I-associated myelopathy (HAM). The main transmission methods are unprotected sexual intercourse, vertical transmission and breastfeeding and direct exposure to infected blood or tissue. The identification of infected mothers prior to delivery is a highly important step in preventing mother to child transmission. Universal antenatal screening for HTLV is not recommended in Romania, although there are sufficient data demonstrating the risk of vertical transmission. We present the case of an HTLV-1-infected pregnant woman, with an aim to highlight: i) points of strategy for the management of HTLV during pregnancy; ii) the particularities of the course of pregnancy; and iii) the aspects that show the importance of knowing the status regarding the HTLV infection antepartum. The case was particular due to the ascendant proviral load during the pregnancy period, which led to the initiation of antiretroviral therapy and the particular pregnancy outcome with preterm rupture of membranes and fetal growth restriction. According to current recommendations, pregnant women infected with HTLV-1 should be advised to refrain from donating blood, body organs, or other tissues. There is no evidence of the number of individuals infected with this virus in Romania at present, and the diagnosis can only occur by chance. A specific treatment or immunization for HTLV infection does not currently exist, thus preventive methods are the only tool to reduce the prevalence and mortality of this infection.
人类嗜T淋巴细胞病毒（HTLV）被认为是现存最具致癌性的病毒，是导致多种致命疾病的病因，如成人T细胞白血病淋巴瘤（ATL）和HTLV-I相关脊髓病（HAM）。其主要传播途径为无保护性行为、垂直传播、母乳喂养以及直接接触受感染的血液或组织。在分娩前识别感染母亲是预防母婴传播的极为重要的一步。尽管有充分数据表明存在垂直传播风险，但罗马尼亚不建议对HTLV进行普遍的产前筛查。我们报告一例HTLV-1感染的孕妇病例，旨在强调：i）孕期HTLV管理的策略要点；ii）孕期过程的特殊性；iii）产前了解HTLV感染状况的重要性方面。该病例较为特殊，因为孕期前病毒载量上升，导致开始抗逆转录病毒治疗，以及出现胎膜早破和胎儿生长受限的特殊妊娠结局。根据当前建议，感染HTLV-1的孕妇应被建议避免献血、捐献身体器官或其他组织。目前尚无罗马尼亚感染该病毒的个体数量的证据，且诊断只能偶然发生。目前不存在针对HTLV感染的特异性治疗或免疫方法，因此预防措施是降低该感染患病率和死亡率的唯一手段。
