Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru

Abstract

Background. Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2) Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. (3) Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.

HTLV-1 Is Also a Sexually Transmitted Infection

“…HTLV-1 has a global distribution: spanning Japan, the Caribbean Islands, South America, West and Central Africa, Romania, parts of the Middle East (Iran), and Central Australia ( 4 ). In Peru, it is estimated that this virus affects 1–2% of the population ( 5 ), with a recent systematic review and meta-analysis finding a pooled proportion of HTLV-1 of 2.34% in the general population of the country (95% CI; 1.96–2.75%; I 2 = 95.51%) ( 6 ). A study carried out in the Quechua population from the provinces of Cangallo, Vilcashuaman, and Parinacochas found HTLV-1 in two of the three included villages ( 5 ).…”

Soroprevalência de HTLV em gestantes: revisão integrativa

“…Conforme a Organização Mundial de Saúde (OMS) e Academia Americana de Pediatria, para o recém-nascido, o alimento mais aconselhado é o leite humano, logo é inestimável pelas suas proteínas biologicamente ativas, diversos nutrientes e fatores imunológicos, dispõe de propriedades imunes, neuroendócrinas e anti-infecciosas por conter lysozyme, lactoferrina, leptina, imunoglobulina A (IgA). Porém, para as grávidas com essa comorbidade são aconselhadas, a substituição do leite materno por suplementação de fórmula alimentar (Ramos-Rincón et al, 2021;Rosadas et al, 2020). Contudo, na investigação sobre transmissão, não é empregue no Brasil, seja por via sexual ou TMI, sendo responsáveis pela endemia recorrente no país (Paiva, 2017;Rosadas et al,2020;Prendergast et al, 2019).…”

“…Os meios de propagação do vírus, comumente, ocorrem por aleitamento materno, por transmissão vertical, sexual e parenteral (Ramos-Rincón et al, 2021;Yendewa et al, 2021). Na epidemiologia, determinam precauções para o controle e prevenção aos cônjuges, pais, filhos, ou seja, aos que mantêm maior contacto com um soroprevalênte (Aquilo, Ramos, 2019).…”

Seroprevalence of maternal peripartum human T-cell lymphotropic virus type-1 infection: a systematic review and meta-analysis of the Nigerian literature

“…To calculate the pooled prevalence, Logit transformation was performed in advance for the prevalence range as most of our data reported less than 0.2 or greater than 0.8 effect size estimate, hence they have become less likely to be normally distributed. 21,22,25,26) For pooled data, the I 2 statistic was used to estimate heterogeneity and risk of bias, specifically publication bias, based on the Egger test result. I 2 statistic values of 50% or more were considered to indicate substantial heterogeneity, and the random effects model using the DerSimonian-Laird estimator (DL) was used for the between variance estimator.…”