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Vector borne transmission htlv19/16/2023 ![]() ![]() However, without a screening program in the UK, diagnosis of HTLV-1 infections is usually only made in relation to blood and tissue donor screening, related contact tracing, and rare cases of HTLV-1 associated diseases such as HTLV-1 associated myelopathy (HAM) and Adult T-cell leukemia/lymphoma (ATL) which usually have onset in adult life ( 7). It has been estimated that there are 20,000-30,000 HTLV-1 seropositive people living in England and Wales ( 7). Highlighting cessation of breast-feeding in a public health approach to the elimination of HTLV-1 mother-to-child transmission, whilst also drawing attention to the need for further research in mother to child transmission ( 3). The recent technical report from the World Health Organization on the global health burden of HTLV-1 infection draws attention to the importance of incorporating HTLV-1 testing into antenatal care. Some countries, such as Brazil, are considering introduction of national screening ( 6). Japan has an estimated 800,000 carriers and is the only country with a national antenatal screening programme ( 4), although French Guiana also undertakes antenatal screening ( 5). It is also found in Europe, North America, India and China, with an estimated 5–10 million people infected worldwide ( 2). HTLV-1 is widespread throughout the globe, being endemic in regions of Japan, West and Southern Africa, the Caribbean islands, Iran, some parts of South America, Central Australia and Melanesia ( 2, 3). Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that was first identified in 1979 ( 1). This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. This can occur transplacentally, during the birth process or via breastmilk. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. Japan is currently the only country with a national antenatal screening programme in place. There are an estimated 5–10 million people infected worldwide. Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. 9Department of Obstetrics and Gynaecology, Imperial College Healthcare NHS Trust, London, United Kingdom.8Level 2, Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.7Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. ![]() 6Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom.5National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom.4Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, United Kingdom.3Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.George's, University of London, London, United Kingdom 2Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St.1Department of Paediatrics, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.Drysdale 2,3 †, Mary Boullier 2, Hermione Lyall 4, Lucy Cook 5,6, Graham P. ![]()
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