Barr Rachael S, Drysdale Simon B, Boullier Mary, Lyall Hermione, Cook Lucy, Collins Graham P, Kelly Dominic F, Phelan Lorna, Taylor Graham P
Department of Paediatrics, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom.
Front Med (Lausanne). 2022 Jul 8;9:941647. doi: 10.3389/fmed.2022.941647. eCollection 2022.
Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5-10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.
人类嗜T细胞病毒1型（HTLV-1）是一种人类逆转录病毒，在世界许多地区呈地方性流行。据估计，全球有500万至1000万人感染。日本是目前唯一实施全国产前筛查计划的国家。HTLV-1在成年期主要通过性传播，不过它也可在围产期由母亲传播给孩子。这种传播可经胎盘、分娩过程或通过母乳发生。如果HTLV-1在围产期传播，那么成人T细胞白血病/淋巴瘤的终生风险会从5%升至20%，因此预防HTLV-1的母婴传播是一项公共卫生重点。孕期有可靠的免疫和分子检测可用于HTLV-1诊断，应根据各国情况考虑进行筛查。尤其对于HTLV-1病毒载量高的女性的妊娠，需要进一步研究最佳管理方法。第一步是建立一个国际病例登记处，并监测新生儿和母亲的结局。我们总结了HTLV-1母婴传播的关键风险因素，随后提出了一个实用指南，用于管理孕期及围产期的母亲和婴儿，以降低传播风险。这在临床上具有相关性，目的是减少HTLV-1的母婴传播及其并发症。
