Van Dyke R B, Heneine W, Perrin M E, Rudolph D, Starszak E, Woods T, Switzer W M, Kaplan J E
Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana.
J Pediatr. 1995 Dec;127(6):924-8. doi: 10.1016/s0022-3476(95)70029-3.
To determine the frequency of mother-to-child transmission of human T-lymphotropic virus type II (HTLV-II) and to explore its association with breast-feeding.
Prospective study of children born to a cohort of HTLV-II-infected pregnant women and a cross-sectional study of older siblings of these children.
Maternal sera were screened with an HTLV-I enzyme immunoassay that detects antibody to both HTLV-I and HTLV-II. Confirmatory serologic testing and viral typing were performed by Western blot, radioimmunoprecipitation assay, enzyme immunoassay with HTLV type-specific proteins, and polymerase chain reaction (PCR) analysis of DNA from peripheral blood mononuclear cells. The presence of HTLV was evaluated in children by serial serologic and PCR testing. Molecular analysis of PCR products from infected mother-child pairs was performed by means of restriction fragment length polymorphism of HTLV-II long-terminal repeated sequences.
Twenty-nine HTLV-II-infected women were identified, and these 29 women had 30 pregnancies during the study. Of 28 live infants born to infected women, 19 were examined and none was infected with HTLV-II. Sixteen older children less than 10 years of age who were born previously to the infected women were also examined; two were infected with HTLV-II. One infected child was breast fed for 2 months and the second was not breast fed. The viral patterns of restriction fragment length polymorphism in the two infected children were distinct, but the viral pattern in each child was identical to that of her mother's virus, suggesting mother-to-child transmission. Overall, among examined children, 1 of 7 breast-fed children (14%; 95% confidence interval: 0, 40) and 1 of 28 children who were not breast fed (3.6%; 95% confidence interval: 0, 10) were infected with HTLV-II.
Mother-to-child transmission of HTLV-II occurs both with and without breast-feeding and at rates similar to those of HTLV-I. We believe that this is the first demonstration of mother-to-child transmission of HTLV-II in the absence of breast-feeding.
确定人类嗜T淋巴细胞病毒II型（HTLV-II）母婴传播的频率，并探讨其与母乳喂养的关系。
对一组HTLV-II感染孕妇所生儿童进行前瞻性研究，并对这些儿童的年长同胞进行横断面研究。
用一种能检测HTLV-I和HTLV-II抗体的HTLV-I酶免疫测定法对孕妇血清进行筛查。通过蛋白质印迹法、放射免疫沉淀测定法、用HTLV型特异性蛋白的酶免疫测定法以及对外周血单个核细胞DNA进行聚合酶链反应（PCR）分析来进行确证性血清学检测和病毒分型。通过系列血清学和PCR检测评估儿童中HTLV的存在情况。对感染的母婴对的PCR产物进行分子分析，采用HTLV-II长末端重复序列的限制性片段长度多态性方法。
确定了29名HTLV-II感染女性，在研究期间这29名女性有30次妊娠。在感染女性所生的28名活产婴儿中，对19名进行了检查，无一感染HTLV-II。还检查了16名感染女性之前所生的10岁以下年长儿童；2名感染了HTLV-II。一名感染儿童母乳喂养了2个月，另一名未母乳喂养。两名感染儿童的限制性片段长度多态性病毒模式不同，但每个儿童的病毒模式与其母亲的病毒模式相同，提示母婴传播。总体而言，在接受检查的儿童中，7名母乳喂养儿童中有1名（14%；95%置信区间：0，40）感染了HTLV-II，28名非母乳喂养儿童中有1名（3.6%；95%置信区间：0，10）感染了HTLV-II。
HTLV-II母婴传播在母乳喂养和非母乳喂养情况下均会发生，发生率与HTLV-I相似。我们认为这是首次证明在无母乳喂养情况下HTLV-II的母婴传播。
