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  • Title: Vertical transmission of HTLV-I/II: a review.
    Author: Bittencourt AL.
    Journal: Rev Inst Med Trop Sao Paulo; 1998; 40(4):245-51. PubMed ID: 9876439.
    Abstract:
    The vertical transmission of the human T-cell lymphotropic virus type I (HTLV-I) occurs predominantly through breast-feeding. Since some bottle-fed children born to carrier mothers still remain seropositive with a frequency that varies from 3.3% to 12.8%, an alternative pathway of vertical transmission must be considered. The prevalence rate of vertical transmission observed in Japan varied from 15% to 25% in different surveys. In Brazil there is no evaluation of this form of transmission until now. However, it is known that in Salvador, Bahia, 0.7% to 0.88% of pregnant women of low socio-economic class are HTLV-I carriers. Furthermore the occurrence of many cases of adult T-cell leukemia/lymphoma and of four cases of infective dermatitis in Salvador, diseases directly linked to the vertical transmission of HTLV-I, indicates the importance of this route of infection among us. Through prenatal screening for HTLV-I and the refraining from breast-feeding a reduction of approximately 80% of vertical transmission has been observed in Japan. We suggest that in Brazil serologic screening for HTLV-I infection must be done for selected groups in the prenatal care: pregnant women from endemic areas, Japanese immigrants or Japanese descendents, intravenous drug users (IDU) or women whose partners are IDU, Human immunodeficiency virus carriers, pregnant women with promiscuous sexual behavior and pregnant women that have received blood transfusions in areas where blood donors screening is not performed. There are in the literature few reports demonstrating the vertical transmission of HTLV-II. HTLV-I is endemic in southwestern and northern Japan, Africa, Australia, Alaska, South America, and the Caribbean. HTLV-I is transmitted vertically mainly through breast-feeding. However, since some bottle-fed children born to carrier mothers remain seropositive with a frequency of 3.3-12.8%, an alternative pathway of vertical transmission must be considered. Surveys in Japan have found prevalence rates of vertical HTLV-I transmission of 15-25%. In Salvador-Bahia, Brazil, 0.7-0.88% of low income, pregnant women carry HTLV-I. The occurrence of many cases of adult T-cell leukemia/lymphoma and of 4 cases of infective dermatitis in Salvador, diseases directly linked to the vertical transmission of HTLV-I, points to the importance of this route of infection. Prenatal screening and refraining from breast-feeding has led to an 80% reduction in the level of vertical transmission in Japan. In Brazil, serologic screening for HTLV-I infection should be performed upon pregnant women from endemic areas, Japanese immigrants or Japanese descendants, IV drug users (IVDU) or women whose partners are IVDUs, HIV carriers, pregnant women with promiscuous sexual behavior, and pregnant women who have received blood transfusions in areas where blood screening is not conducted. Associated diseases, viral transmission through breast-feeding, other means of vertical transmission, mechanisms of the transplacental transmission of HTLV-I, risk factors for vertical transmission, the diagnosis and prevention of vertical transmission, and HTLV-II are discussed.
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