How Can We Prevent Mother-to-Child Transmission of HTLV-1?

Abstract

The perception of human T-cell leukemia virus type 1 (HTlV-1) infection as a “silent disease” has recently given way to concern that its presence may be having a variety of effects. HTLV-1 is known to cause adult T-cell leukemia (ATL), an aggressive cancer of peripheral CD4 T cells; however, it is also responsible for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Most patients develop ATL as a result of HTLV-1 mother-to-child transmission. The primary route of mother-to-child transmission is through the mother’s milk. In the absence of effective drug therapy, total artificial nutrition such as exclusive formula feeding is a reliable means of preventing mother-to-child transmission after birth, except for a small percentage of prenatal infections. A recent study found that the rate of mother-to-child transmission with short-term breastfeeding (within 90 days) did not exceed that of total artificial nutrition. Because these preventive measures are in exchange for the benefits of breastfeeding, clinical applications of antiretroviral drugs and immunotherapy with vaccines and neutralizing antibodies are urgently needed.

Milk Transmission of Mammalian Retroviruses

“…Mother-to-child transmission (MTCT) predominantly occurs via breastfeeding (ca. 80 % of MTCT) since abstaining from breastfeeding, or feeding for less than 90 days, can extremely reduce MTCT [ 174 , 175 ]. The risk factors for MTCT upon breastfeeding have been reviewed earlier, including amongst others high proviral load in milk and blood as well as prolonged breastfeeding periods for more than 6 months [ 176 , 177 ].…”

Understanding the Immunopathology of HTLV-1-Associated Adult T-Cell Leukemia/Lymphoma: A Comprehensive Review

“…The main routes of HTLV-1 infection differ by country. In Japan, mother-to-child transmission via breast milk predominates, whereas in South America and Africa, horizontal transmission is also common [11][12][13]. ATL cells have a mature T-cell phenotype with characteristic multi-lobulated nuclei, known as "flower cells," and the typical activated T-cell phenotype of ATL cells includes the surface markers CD4+ and CD25+ [14].…”

The Interactions between Cells and Viruses

“…The review by Itabashi et al [43] summarized the current knowledge of HTLV-1 mother-to-child transmission (MTCT). HTLV-1 causes adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis [44].…”