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人类嗜T淋巴细胞病毒1型的隐匿传播:巴西一家参考中心的家庭内传播证据

Silent dissemination of HTLV-1: evidence of intrafamilial transmission in a Brazilian reference centre.

作者信息

Alves Daniele Leite, Silva Roberta Muniz Luz, Santos João Pedro Melo de Freitas, Amorim Rebeca Leão, Santana Carolina Souza, Andrade Felipe de Oliveira, Ribeiro Saadia Oliveira, Costa Giselle Calasans de Souza, Santos Luciane Amorim, Costa Davi Tanajura, Barreto Fernanda Khouri

机构信息

Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista, BA, Brasil.

Laboratório Central de Vitória da Conquista, Vitória da Conquista, BA, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2025 Mar 31;120:e240191. doi: 10.1590/0074-02760240191. eCollection 2025.

Abstract

BACKGROUND

The HTLV-1 affects 5 to 10 million people worldwide. It is estimated that 5 to 10% of the infected individuals develop severe diseases, such as HTLV-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) or Adult T-Cell Leukaemia/Lymphoma (ATLL). HTLV-1 transmission can occur mainly through unprotected sexual contact and from mother to child during breastfeeding. No vaccines can contain this infection, and strategies to prevent transmission become a priority. Therefore, it is important to know the main dissemination routes of each region to design the best public health strategies for controlling the spread of this virus.

OBJECTIVES

This study aimed to evaluate the prevalence of family aggregation in HTLV-1 infection among patients treated at a reference centre in Brazil.

METHODS

A cross-sectional study was conducted with patients between July 2021 and August 2022. A total of 67 individuals were attended, of which 17 were classified as index cases due to a history of family aggregation, with 120 family contacts.

FINDINGS

We found a prevalence of 36% of individuals positive for HTLV-1 and the same for HTLV-1 negative, while 28% of the family members had unknown serology. The possible transmission routes were identified, and the familial transmission histories within each family were hypothesised.

MAIN CONCLUSIONS

These data can support specific decisions regarding the local reality, such as a better health strategy, especially in preventing new HTLV-1 cases.

摘要

背景

人类嗜T淋巴细胞病毒1型(HTLV-1)在全球感染500万至1000万人。据估计,5%至10%的感染者会发展为严重疾病,如HTLV相关脊髓病/热带痉挛性截瘫(HAM/TSP)或成人T细胞白血病/淋巴瘤(ATLL)。HTLV-1的传播主要通过无保护的性接触以及母乳喂养期间的母婴传播。目前尚无疫苗可预防这种感染,因此预防传播策略成为当务之急。所以,了解每个地区的主要传播途径对于制定控制该病毒传播的最佳公共卫生策略至关重要。

目的

本研究旨在评估巴西一家参考中心接受治疗的患者中HTLV-1感染的家庭聚集患病率。

方法

于2021年7月至2022年8月对患者进行了一项横断面研究。共诊治67人,其中17人因有家庭聚集病史被列为索引病例,有120名家庭接触者。

结果

我们发现HTLV-1阳性个体的患病率为36%,HTLV-1阴性个体的患病率也为36%,而28%的家庭成员血清学情况未知。确定了可能的传播途径,并对每个家庭内部的家族传播史进行了推测。

主要结论

这些数据可为针对当地实际情况的具体决策提供支持,例如制定更好的健康策略,尤其是在预防新的HTLV-1病例方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4692/11964092/8574e382deeb/1678-8060-mioc-120-e240191-gf1.jpg

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