A Nationwide Antenatal Human T-Cell Leukemia Virus Type-1 Antibody Screening in Japan

Itabashi, Kazuo; Miyazawa, Tokuo; Sekizawa, Akihiko; Tokita, Akifumi; Saito, Shigeru; Moriuchi, Hiroyuki; Nerome, Yasuhito; Uchimaru, Kaoru; Watanabe, Toshiki

doi:10.3389/fmicb.2020.00595

Cited by 30 publications

(45 citation statements)

References 79 publications

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“…This may have been influenced by the local infection rate [11,12] and local government's commitment to HTLV-1. Kyushu area was the most endemic area in Japan [15,16]. Facility types were associated with the implementation of the screening and testing.…”

Section: Discussionmentioning

confidence: 99%

“…The local governments collaborated with stakeholders and endorsed the screening program. Japanese Clinical Guidelines for Obstetric Practice (edited in 2011 by the Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists) recommended carrying out a screening test for anti-HTLV-1 antibody using particle agglutination (PA) or chemiluminescent enzyme immunoassay (EIA) with western blotting (WB) and/or polymerase chain reaction (PCR) confirmation in all pregnant women [ 14 , 15 ]. The screening test is performed during early-to-middle pregnancy (up to around 30 weeks of pregnancy).…”

Section: Methodsmentioning

confidence: 99%

“…Diagnosis as an HTLV-1 carrier can usually be determined after the confirmation test (WB test) following a serological screening test performed for all women during pregnancy in Japan since September 2010. According to the Guidelines for Obstetrical Practice in Japan published in 2011, these methods are advised for HTLV-1-positive pregnant women to prevent vertical transmission [ 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

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Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study

et al. 2020

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Background: Screening of pregnant women carrying human T-lymphotropic virus type 1 (HTLV-1) has a crucial role in reducing the number of HTLV-1 carriers. A national HTLV-1 screening program for pregnant women was started in 2011 in Japan. The purpose of this study is to report on the implementation of this nationwide screening program. Methods: This was a retrospective repeated cross-sectional study. We used datasets from surveys of HTLV-1antibody-positive pregnant women performed by the Japan Association of Obstetricians and Gynecologists in 2011, 2013, and 2016. Outcomes for evaluation included the number of persons (pregnant women) who conducted the screening test, the number of positive persons (women) identified by these tests, and the proportion of positive persons to the number of persons (women) who conducted the tests. Results: Numbers of target facilities changed yearly: 1857 in 2011, 2544 in 2013, and 2376 in 2016. The mean number of screening-test participants increased per facility, but the median increased or decreased. The mean number of positive individuals identified decreased. Multivariate analysis results revealed the number of screenings was slightly reduced yearly, although areas (Kanto and Kinki) and high volume in facility types increased. Regarding the positive rates, some areas (Hokkaido/Tohoku, Kanto, and Chugoku/Shikoku) exhibited decreases or increases by facility type. The number of western blotting (WB) implementations decreased in 2016, positive rates identified by WB decreased in 2016 in all areas, and the number of facility types increased. The number of PCR participants increased in 2016 in Kanto and Kinki, but a decrease in facility type was observed. Positive rates were decreased in all areas (except the central region) but facility types were increased. Conclusions: The nationwide screening program for HTLV-1 in Japan was almost fully implemented. However, regional variations in screening tests were observed during this implementation. Thus, some incentives are needed to encourage proper implementation across all regions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study

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“…12 While some healthcare providers in Japan have recommended STBF 11,13 or frozen-thawed breast-milk feeding (FTBMF) 14,15 as alternatives to ExFF, there is insufficient evidence regarding the effects of STBF and FTBMF on the incidence of MTCT. 12 Despite the increased risk of MTCT from longer term breast-feeding, 11,13 the proportion of mothers who select STBF and refrain from breast-feeding by 3 months remains unknown. Serological testing for the children born to pregnant carriers is not mandatory under the screening program, so we do not know what proportion of the children will undergo serological antibody testing.…”

mentioning

confidence: 99%

“…showed that the prevalence of HTLV‐1 antibody among children breast‐fed for over 3 months was significantly higher than that of those breast‐fed for under 3 months 11 . Thus, in Japan, short‐term breast‐feeding (STBF) is generally defined as breast‐feeding up to 3 months of age 12 …”

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confidence: 99%

Issues of infant feeding for postnatal prevention of human T‐cell leukemia/lymphoma virus type‐1 mother‐to‐child transmission

Itabashi

Miyazawa

Nerome

et al. 2021

Pediatrics International

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Background: Nationwide antenatal human T-cell leukemia/lymphoma virus type-1 (HTLV-1) antibody screening has been conducted in Japan. The purpose of our study was to clarify the issues related to feeding options to prevent postnatal mother-to-child transmission. Methods: Of the pregnant carriers at 92 facilities in Japan between 2012 and 2015, 735 were followed prospectively. Among the children born to them, 313 (42.6%) children were followed up to the age of 3 and tested for HTLV-1 antibodies. The mother-to-child transmission rate was calculated for each feeding option selected before birth. Results: Among the 313 pregnant carriers, 55.0, 35.1, 6.1, and 3.8% selected short-term breast-feeding (≤3 months), exclusive formula feeding, frozen-thawed breast-milk feeding, and longer-term breast-feeding, respectively. Despite short-term breast-feeding, 8-18% of the mothers continued breast-feeding for 4-6 months. The mother-to-child transmission rate with short-term breast-feeding was 2.3% (4/172), and its risk ratio compared with that of exclusive formula feeding was not significantly different (0.365; 95% CI: 0.116-1.145). Because of the small number of children who were fed by frozen-thawed breast-milk, their mother-to-child transmission rate was not statistically reliable. Conclusions: Pregnant HTLV-1 carriers tended to select short-term breast-feeding in Japan. While short-term breast-feeding was not always easy to wean within 3 months, it may be a viable option for preventing postnatal mother-to-child transmission because the vertical transmission rate with short-term breast-feeding was not significantly higher than that with exclusive formula feeding. Increasing the follow-up rates for children born to pregnant carriers may provide clearer evidence of preventative effects by short-term breast-feeding and frozen-thawed breastmilk feeding.

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Rigosertib is more potent than wortmannin and rapamycin against adult T‐cell leukemia‐lymphoma

Ghorbanzadeh Neghab,

Jalili‐Nik,

Soltani

et al. 2023

BioFactors

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Human T lymphotropic virus type 1 (HTLV‐1) infection can cause adult T‐cell lymphoblastic leukemia (ATLL), an incurable, chemotherapy‐resistant malignancy. In a quest for new therapeutic targets, our study sought to determine the levels of AKT, mTOR, and PI3K in ATLL MT‐2 cells, HTLV‐1 infected NIH/3T3 cells (Inf‐3T3), and HTLV‐1 infected patients (Carrier, HAM/TSP, and ATLL). Furthermore, the effects of rigosertib, wortmannin, and rapamycin on the PI3K/Akt/mTOR pathway to inhibit the proliferation of ATLL cells were examined. The results showed that mRNA expression of Akt/PI3K/mTOR was down‐regulated in carrier, HAM/TSP, and ATLL patients, as well as MT‐2, and Inf‐3T3 cells, compared to the healthy individuals and untreated MT‐2 and Inf‐3T3 as controls. However, western blotting revealed an increase in the phosphorylated and activated forms of AKT and mTOR. Treating the cells with rapamycin, wortmannin, and rigosertib decreased the phosphorylated forms of Akt and mTOR and restored their mRNA expression levels. Using these inhibitors also significantly boosted the expression of the pro‐apoptotic genes, Bax/Bcl‐2 ratio as well as the expression of the tumor suppressor gene p53 in the MT‐2 and Inf‐3T3cells. Rigosertib was more potent than wortmannin and rapamycin in inducing sub‐G1 and G2‐M cell cycle arrest, as well as late apoptosis in the Inf‐3T3 and MT‐2 cells. It also synergized the cytotoxic effects of vincristine. These findings demonstrate that HTLV‐1 downregulation of the mRNA level may occur as a negative feedback response to increased PI3K‐Akt‐mTOR phosphorylation by HTLV‐1. Therefore, using rigosertib alone or in combination with common chemotherapy drugs may be beneficial in ATLL patients.

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A Nationwide Antenatal Human T-Cell Leukemia Virus Type-1 Antibody Screening in Japan

Cited by 30 publications

References 79 publications

Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study

Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study

Issues of infant feeding for postnatal prevention of human T‐cell leukemia/lymphoma virus type‐1 mother‐to‐child transmission

Rigosertib is more potent than wortmannin and rapamycin against adult T‐cell leukemia‐lymphoma

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