Risk factors associated with HTLV-1 vertical transmission in Brazil: longer breastfeeding, higher maternal proviral load and previous HTLV-l-infected offspring

Author(s)

Paiva, Arthur M. ^{[1, 2]} ; Assone, Tatiane ^[1] ; Haziot, Michel E. J. ^[3] ; Smid, Jerusa ^[3] ; Fonseca, Luiz Augusto M. ^[4] ; Luiz, Olinda do Carmo ^[5] ; Penalva de Oliveira, Augusto Cesar ^[3] ; Casseb, Jorge ^{[1, 6]}

Affiliation

^[1] Univ Sao Paulo, Inst Med Trop Sao Paulo, Lab Imunol & Dermatol, LIM 56, Sao Paulo, SP - Brazil

^[2] Univ Fed Alagoas, Hosp Univ Prof Alberto Antunes, Alagoas - Brazil

^[3] Secretaria Saude Estado Sao Paulo, Inst Infectol Emilio Ribas, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Serv Alergia & Imunol, Fac Med FMUSP, Sao Paulo, SP - Brazil

^[5] Univ Sao Paulo, Med Sch, Dept Prevent Med, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Dept Med Prevent, Fac Med FMUSP, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 8, MAY 17 2018.
• Web of Science Citations: 4

Abstract

HTLV-1 is transmitted primarily either through sexual intercourse or from mother to child. The mother/child pairs were classified as seroconcordant or serodiscordant. We analyzed mother to child transmission (MTCT) according to sociodemographic, clinical and epidemiological characteristics of the mother, child's gender and duration of breastfeeding. Between June 2006 and August 2016 we followed 192 mothers with HTLV-1 infection (mean age 41 years old), resulting in 499 exposed offspring, 288 (57.7%) of whom were tested for HTLV-1, making up the final sample for the study, along with their 134 respective mothers. Among the tested mother/child pairs, 41 (14.2%) were HTLV-1 positive, highlighted that seven of 134 family clusters concentrated 48.8% of positive cases. Variables associated with a positive child: breastfeeding duration >= 12 months, maternal PVL >= 100 copies/10(4) PBMC, mother's age at delivery >26 years old, and HTLV-1 in more than one child of the same mother. In a multiple logistic regression, breastfeeding >= 12 months, higher maternal PVL and >= 2 previous HTLV-l-infected children remained independently associated with the outcome. Thus, high maternal PVL and breastfeeding beyond 12 months were independently associated with MTCT of the HTLV-1 infection. Our results reinforce the need for both prenatal HTLV screening in endemic areas and for advising mothers on breastfeeding. (AU)

• FAPESP's process: 14/22827-7 - Prevalence and incidence of early central nervous system disturbance in HTLV-1-infected subjects in Brazil
• Grantee: Jorge Simao do Rosario Casseb
• Support Opportunities: Regular Research Grants
• FAPESP's process: 16/03025-2 - Identification of polymorphisms related to HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM / TSP)
• Grantee: Tatiane Assone Casseb
• Support Opportunities: Scholarships in Brazil - Post-Doctoral