巴西 HTLV-1 感染率最高的州——巴伊亚州，通过性和垂直途径的家族内传播的流行病学和分子证据。
Epidemiological and molecular evidence of intrafamilial transmission through sexual and vertical routes in Bahia, the state with the highest prevalence of HTLV-1 in Brazil.
机构信息
Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil.
Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
出版信息
PLoS Negl Trop Dis. 2023 Sep 28;17(9):e0011005. doi: 10.1371/journal.pntd.0011005. eCollection 2023 Sep.
INTRODUCTION
Familial clustering of HTLV-1 and related diseases has been reported in Brazil. However, intrafamilial transmission of HTLV-1 based on molecular analysis has been studied only in a few communities of Japanese immigrants and African-Brazilians.
OBJECTIVE
To investigate the familial clustering of HTLV-1 infection and to determine the likely routes of transmission through epidemiological and genetic analyzes.
METHODS
Medical records of 1,759 HTLV-1+ patients from de the Center for HTLV in Salvador, Brazil, were evaluated to identify first-degree relatives previously tested for HTLV-1. Familial clustering was assumed if more than one member of the same family was HTLV-1+. LTR regions of HTLV-1 sequences were analyzed for the presence of intrafamilial polymorphisms. Family pedigrees were constructed and analyzed to infer the likely transmission routes of HTLV-1.
RESULTS
In 154 patients at least one other family member had tested positive for HTLV-1 (a total of 182 first-degree relatives). Of the 91 couples (182 individuals), 51.6% were breastfed, and 67.4% reported never using a condom. Of the 42 mother-child pairs, 23.8% had a child aged 13 years or younger; all mothers reported breastfeeding their babies. Pedigrees of families with 4 or more members suggests that vertical transmission is a likely mode of transmission in three families. Three families may have had both vertical and sexual transmission routes for HTLV-1. The genetic signatures of the LTR region of 8 families revealed 3 families with evidence of vertical transmission, another 3 families (spouses) with sexual transmission, and one family with both transmission routes. HTLV-1 sequences belonged to Cosmopolitan subtype HTLV-1a Transcontinental subgroup A.
CONCLUSION
Sexual and vertical transmission routes contribute to the intrafamilial spread of HTLV-1 in the state of Bahia.
引言
在巴西，已经有报道称 HTLV-1 及其相关疾病存在家族聚集现象。然而，基于分子分析的 HTLV-1 家族内传播仅在少数日本移民和非裔巴西人群体中进行了研究。
目的
调查 HTLV-1 感染的家族聚集性，并通过流行病学和遗传分析确定可能的传播途径。
方法
对来自巴西萨尔瓦多 HTLV 中心的 1759 名 HTLV-1+患者的病历进行评估，以确定之前接受过 HTLV-1 检测的一级亲属。如果同一个家庭中有多个成员为 HTLV-1+，则认为存在家族聚集。分析 HTLV-1 序列的 LTR 区，以确定是否存在家族内多态性。构建和分析家族系谱，以推断 HTLV-1 的可能传播途径。
结果
在 154 名患者中，至少有一名其他家庭成员的 HTLV-1 检测结果为阳性（共有 182 名一级亲属）。在 91 对夫妇（182 人）中，51.6%的人进行了母乳喂养，67.4%的人报告从未使用过避孕套。在 42 对母婴中，23.8%的孩子年龄在 13 岁或以下；所有母亲均报告母乳喂养婴儿。有 4 个或更多成员的家庭系谱表明，垂直传播可能是 3 个家庭的传播模式。3 个家庭可能同时存在垂直和性传播途径。8 个家庭的 LTR 区遗传特征显示，3 个家庭存在垂直传播证据，另外 3 个家庭（配偶）存在性传播，1 个家庭存在两种传播途径。HTLV-1 序列属于世界性 HTLV-1a 跨大陆亚群 A。
结论
性传播和垂直传播途径导致 HTLV-1 在巴伊亚州的家族内传播。
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