Uchimaru Kaoru
IMSUT Hospital, Institute of Medical Science, The University of Tokyo.
Rinsho Ketsueki. 2021;62(7):751-759. doi: 10.11406/rinketsu.62.751.
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.
HTLV-1携带者的数量是通过抗HTLV-1抗体阳性献血者的比例来估算的。在日本，约有82万人携带HTLV-1。预防HTLV-1感染的策略包括对孕妇进行抗HTLV-1抗体筛查，以及建议HTLV-1抗体阳性的母亲采用配方奶喂养，以防止HTLV-1的母婴传播。然而，无法进行母乳喂养的母亲会感到悲伤，因此为这些母亲提供心理健康护理很重要。开发针对HTLV-1携带者的咨询系统也很重要。针对HTLV-1携带者的咨询和随访的基础制度体系正在不断发展。HTLV-1携带者管理中的第三个重要问题是识别患成人T细胞白血病（ATL）的高危携带者。基于JSPFAD（成人T细胞白血病发展易感因素联合研究）等登记系统，危险因素的识别、流式细胞术分析以及使用靶向序列技术检测基因组突变都有所改进。对危险因素的研究将揭示从HTLV-1感染细胞发展为ATL的机制。通过这些研究努力，有望开发出用于ATL抢先治疗和预防治疗的有效药物。
