Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies

Mendoza, Carmen de; Pérez, Leire; Fernández‐Ruiz, Mario; Pena, María José; Ramos, José Manuel; Richart, Alberto; Pirón, María; Rando, Ariadna; Miró, Elisenda; Reina, Gabriel; Encinas, Beatriz; Rojo, Silvia; Rodriguez-Iglesias, Antonio Manuel; Benito, Rafael; Aguilera, Antonio; Treviño, Ana; Corral, Octavio; Soriano, Vincent

doi:10.1016/j.ijid.2022.07.043

Cited by 8 publications

(6 citation statements)

References 24 publications

(32 reference statements)

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“…Spain, Sweden, the Netherlands and France -high-income countries with overall low prevalence of HTLV-1 infection in the general population, but with high prevalence in specific population groups. Thus, our results would be applicable if the costs of intervention and the impact of HTLV-1-associated diseases are similar and within the ranges used here [27]. The WHO reports that France is the only European country where HTLV-1 selective antenatal screening is offered but is restricted to French Caribbean territories [6].…”

Section: Discussionmentioning

confidence: 67%

Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021

Rosadas,

Costa,

Senna

et al. 2024

Eurosurveillance

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Background Human T-cell lymphotropic virus type 1 (HTLV-1) is a neglected virus that can cause severe disease and be transmitted from mother to child through breastfeeding. Avoidance of breastfeeding prevents 80% of vertical transmission. The United Kingdom (UK) is currently assessing whether HTLV-1-targeted antenatal screening should be implemented. Aim We aimed to assess the impact and cost-effectiveness of a targeted programme to prevent HTLV-1 vertical transmission in England and Wales. Methods We estimated the number of pregnant women who have high risk of HTLV-1 infection based on their or their partner’s country of birth. With data from 2021, we used a mathematical model to assess cost-effectiveness of HTLV-1 antenatal screening. We also estimated the annual number of infant infections and the number that could be prevented with screening and intervention. Results We estimate that ca 99,000 pregnant women in England and Wales have high risk of HTLV-1 infection. In the absence of screening, 74 (range: 25–211) HTLV-1 infections in infants would be expected to occur every year in England and Wales. Implementation of targeted screening would prevent 58 (range: 19–164) infant infections annually. The intervention is effective (incremental 0.00333 quality-adjusted life years (QALY)) and cost-saving (GBP −57.56 (EUR −66.85)). Conclusion Our findings support implementation of HTLV-1 targeted antenatal screening to reduce vertical transmission from mothers to infants in the UK.

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Section: Discussionmentioning

confidence: 67%

Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021

Rosadas,

Costa,

Senna

et al. 2024

Eurosurveillance

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“…syphilis, gonorrhea, chlamydia and mycoplasma, testing for other less frequent etiologies is increasingly becoming cost-effective and informative in terms of public health. We and others support that this should be the case for HTLV-1; which should be added into the STI screening list [34][35][36]. Antiretrovirals used as HIV PreP include nucleos(t)ide reverse transcriptase inhibitors and integrase inhibitors.…”

Section: Hbvmentioning

confidence: 99%

“…Only in this way, asymptomatic HTLV-1 carriers can be unveiled, start periodic clinical follow-up and be informed about the risks of transmission. In this regard, testing of sex partners and avoiding breastfeeding are very effective measures [34].…”

Section: Hbvmentioning

confidence: 99%

Pre-Exposure Prophylaxis for viral infections other than HIV

et al. 2022

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The battle against human viral infections has historically relied on two medical strategies, namely vaccines to protect from contagion and antivirals to treat infected patients. In the absence of vaccines, antivirals have occasionally been used as peri-exposure prophylaxis, given either before (pre-exposure prophylaxis) or right after (post-exposure prophylaxis). In an unprecedented way, the use of antiretrovirals as chemoprophylaxis has triumphed in the HIV field. Indeed, oral antiretrovirals given either daily or at demand to HIV-uninfected individuals engaged in high-risk behaviors protect from contagion. More recently, the advent of long-acting formulations has allowed HIV protection following intramuscular injections every three months. Can SUMMARY we envision a similar prophylactic strategy for other human viral infections?The advent of such 'chemical vaccines' would fill an unmet need when classical vaccines do not exist, cannot be recommended, immune responses are suboptimal, escape mutants emerge or immunity wanes. In this review, we discuss the opportunities for antiviral chemoprophylaxis for viral hepatitis B and C, retroviruses HTLV-1 and HIV-2, and respiratory viruses influenza and SARS-CoV-2, among others.

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“…Most had acquired the infection throughout sexual contact, although vertical transmission was suspected for 10%. Late presentation was relatively frequent due to poor clinical suspicion and testing 19 . Overall, 22% of patients first appeared with clinical manifestations, mostly subacute myelopathy or T‐cell leukemias/lymphomas 20 .…”

Section: Htlv‐1 Epidemicsmentioning

confidence: 99%

“…There she had received transfusions for managing episodes of malaria. She developed paraparesis years later and Late presentation was relatively frequent due to poor clinical suspicion and testing 19. Overall, 22% of patients first appeared with clinical manifestations, mostly subacute myelopathy or T-cell leukemias/lymphomas 20.…”

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confidence: 99%

The slowdown of new infections by human retroviruses has reached a plateau in Spain

Mendoza

Carrizo

Sauleda

et al. 2023

Journal of Medical Virology

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The 2022 annual meeting of the HTLV & HIV-2 Spanish Network was held in Madrid on December 14. We summarize here the main information presented and discussed at the workshop and review time trends for human retroviral infections in Spain. As transmissible agents, infections by human retroviruses are of obligatory declaration.Until the end of 2022, the Spanish national registry had recorded 451 cases of HTLV-1, 821 of HTLV-2, and 416 of HIV-2. For HIV-1, estimates are of 150 000 people currently living with HIV-1 and 60 000 cumulative deaths due to AIDS.During year 2022, new diagnoses in Spain were of 22 for HTLV-1, 6 for HTLV-2, and 7 for HIV-2. The last updated figures for HIV-1 are from 2021 and counted 2786 new diagnoses. The slowdown in yearly infections for HIV-1 in Spain points out that new strategies are needed to achieve the United Nations 95-95-95 targets by 2025.

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Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies

Cited by 8 publications

References 24 publications

Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021

Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021

Pre-Exposure Prophylaxis for viral infections other than HIV

The slowdown of new infections by human retroviruses has reached a plateau in Spain

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