Molecular detection of human T cell lymphotropic virus type 1 in pregnant women from Maranhão state, Brazil

Abstract

The human T cell lymphotropic virus (HTLV) has a worldwide distribution. HTLV is endemic in some states in the northeastern region of Brazil. This study investigated the prevalence of HTLV-1/2 in 713 pregnant women attended at the Central Laboratory of Public Health of Maranhão (LACEN-MA) between February 2015 and May 2017. Serological screening was performed by chemiluminescent microparticle immunoassay (CMIA), and reactive sera were subsequently confirmed by Western blot (WB) analysis. Five samples were determined to be HTLV-1/2-reactive by CMIA analysis, while in the WB analysis, three sera were positive for HTLV-1, and two were indeterminate. The polymerase chain reaction (PCR) analysis used to detect HTLV-1 proviral DNA showed a specific 336 base pair fragment for HTLV-1 in all CMIA-reactive serum samples. PCR products were purified and sequenced. We observed a 0.7% molecular prevalence of HTLV-1 infection. The average age of the HTLV-1-positive pregnant women was 25.6 ± 8.2 years, and the average age of the HTLV-1-negative pregnant women was 24.3 ± 6.2 (p = 0.60). We observed that there was no association of HTLV-1 infection with age, ethnicity, marital status, educational level, family income, age of first sexual intercourse, previous pregnancy, breastfeeding, intravenous drug use by partner, history of blood transfusions, or use of condoms. The prevalence of HTLV-1 observed in pregnant women demonstrated the need to implement public health policies for the screening of HTLV-1/2 in prenatal care and counseling to avoid breastfeeding by infected women; this approach could control vertical transmission and reduce the spread of this virus in the population.

Human T-cell leukemia virus type 1 infection among Japanese immigrants and their descendants living in Southeast Brazil: A call for preventive and control responses

“…There are approximately 1.5 million people of Japanese descent in Brazil and most of them living in São Paulo state [17]. The prevalence of 5.1% (95% CI: 4.2-6.0) of HTLV-1 infection found in this study is higher than those observed in other studies conducted in different regions of the country considering HTLV-1 endemic a ´reas, including Salvador, the city with the highest HTLV-1 prevalence (1.48%) in Brazil [28][29][30][31], and higher than those conducted among specific risk groups, such as men who have sex with men, people who used illicit drugs, HIV-infected persons, and commercial sex workers, with prevalence rates varying from 0.7% to 3.0% [32][33][34][35]. This high rate (5.1%) found in the present study is similar to that observed in previous study involving Japanese community of Campo Grande, Mato Grosso do Sul State (6.8%) [13] probably because the majority of subjects in both studies was descendant of Okinawans as well as of people from other HTLV-1-endemic regions in Japan.…”

The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil

“…In Sao Luiz, the capital city of the State of Maranhao, the highest prevalence rate (1%) among blood banks in Brazil was identified [100], but the prevalence rate among pregnant women ranged from 0.34% (HTLV-1, 0.19% and HTLV-2, 0.15%) [104] to 0.7% (HTLV-1 only) more recently described [115]. Retrospective information on blood donors showed that only 0.15% among more than 365,000 persons tested in the period 2003-2009 were positive for HTLV-1/2 [102], however only 53 persons confirmed the seroreactivity.…”

Prevalence of human T-lymphotropic virus type 1 and 2 (HTLV-1/-2) infection in pregnant women in Brazil: a systematic review and meta-analysis

“…Of these 26 studies evaluated that used confirmatory tests, only 17 reported which types of HTLV were studied and used for quantitative analysis (meta-analysis). Fifteen articles presents data for HTLV-1 and -2 21 , 26 , 33 , 35 , 39 , 40 , 42 , 45 , 46 , 48 – 52 , 54 and two about HTLV-1 43 , 44 . None report data just for HTLV-2.…”

“…Of all studies included in this systematic review, only 5 of HTLV-1 and 4 of HTLV-2 reported the mean age of the participants 26 , 39 , 44 , 52 , 54 , and the range of mean ages was very small (23.9 to 27.0). According to the meta-regression model, age was not associated with the prevalence of HTLV infection, in contrast with the literature.…”