Pregnancy outcomes and mother-to-child transmission rate in HTLV-1/2 infected women attending two public hospitals in the metropolitan area of Rio de Janeiro.

Danielle Bittencourt Sodré Barmpas,Alexandre José Baptista Trajano,Stella Regina Taquette,Denise Leite Maia Monteiro,Juliana De Castro Cunha,Lucia Helena Cavalheiro Villela,Sérgio A M Teixeira,Nádia Cristina Pinheiro Rodrigues,Camila Lattanzi Nunes,Márcio Neves Bóia,Denise Cardoso Das Neves Sztajnbok

doi:10.1371/journal.pntd.0007404

Abstract

HTLV-1/2 are transmitted sexually, by whole cell blood products and from mother-to-child (MTC), mainly through breastfeeding. HTLV-1/2 prevalence in pregnant women is high in Rio de Janeiro, however there were no local studies addressing the rate of adverse pregnancy outcomes (APO) and MTC transmission. The aim was to study sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in HTLV-1/2-positive women. The cross-sectional study screened 1,628 pregnant women in of Rio de Janeiro (2012–2014) and found 12 asymptomatic carrier mothers (prevalence = 0.74%). Pregnancy outcome information was retrieved from medical records. Sociodemographic characteristics were similar between the positive and negative groups except for maternal age, which was higher in carrier mothers. The incidence of adverse pregnancy outcomes was similar in infected and non-infected patients (p = 0.33), however there was a high rate of premature rupture of membranes (PROM) amid infected mothers (3/12). Multilevel logistic regression found that for each additional year of age, the chance of being HTLV-1/2-positive increased 11% and that having another sexually transmitted infection (STI) increased 9 times the chance of being infected. Carrier mothers had more antenatal visits (OR = 5.26). Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. After two years of follow-up there was one case of MTC transmission (1/9). The mother reported breastfeeding for one month only. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy outcomes and the MTC transmission rate is important to guide public health policies on antenatal screening and management.

Highlights

Human T-lymphotropic virus types 1 and 2 (HTLV-1/2) are human oncogenic retroviruses first identified in the early 1980’s [1]
Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy outcomes and the MTC transmission rate is important to guide public health policies on antenatal screening and management
HTLV-1/2 are retroviruses transmitted by sex, blood products and from mother to child (MTC), mainly through breastfeeding

Summary

Introduction

Human T-lymphotropic virus types 1 and 2 (HTLV-1/2) are human oncogenic retroviruses first identified in the early 1980’s [1]. Prevalence is characterized by endemic clusters occurring next to low prevalence areas. Since transmission occurs through infected body fluids, intravenous (IV) drug users and sex workers have been reported as high-risk groups [4]. Endemic HTLV-1 clusters are found in Sub-Saharan Africa, Southwestern Japan, Central and South America as well as the Middle East and Melanesia [4]. HTLV-2 is endemic in Pygmy tribes of Central Africa and in several Native American populations, in the Amazon area [5,6]. It is frequent in IV drug users, often in co-infection with HIV [5,7]

Objectives

Methods

Results

Discussion

Conclusion