Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention

Itabashi, Kazuo; Miyazawa, Tokuo

doi:10.3390/cancers13164100

Cited by 21 publications

(25 citation statements)

References 116 publications

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“…There are two modes of HTLV-1 transmission: horizontal infection and antenatal or postnatal MTCT [ 15 , 54 ]. In 2013, there were an estimated 1780 pregnant carriers in Japan [ 55 ].…”

Section: Modes Of Htlv-1 Transmissionmentioning

confidence: 99%

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How Can We Prevent Mother-to-Child Transmission of HTLV-1?

Itabashi¹,

Miyazawa

Uchimaru

2023

IJMS

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The perception of human T-cell leukemia virus type 1 (HTlV-1) infection as a “silent disease” has recently given way to concern that its presence may be having a variety of effects. HTLV-1 is known to cause adult T-cell leukemia (ATL), an aggressive cancer of peripheral CD4 T cells; however, it is also responsible for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Most patients develop ATL as a result of HTLV-1 mother-to-child transmission. The primary route of mother-to-child transmission is through the mother’s milk. In the absence of effective drug therapy, total artificial nutrition such as exclusive formula feeding is a reliable means of preventing mother-to-child transmission after birth, except for a small percentage of prenatal infections. A recent study found that the rate of mother-to-child transmission with short-term breastfeeding (within 90 days) did not exceed that of total artificial nutrition. Because these preventive measures are in exchange for the benefits of breastfeeding, clinical applications of antiretroviral drugs and immunotherapy with vaccines and neutralizing antibodies are urgently needed.

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“…There are two modes of HTLV-1 transmission: horizontal infection and antenatal or postnatal MTCT [ 15 , 54 ]. In 2013, there were an estimated 1780 pregnant carriers in Japan [ 55 ].…”

Section: Modes Of Htlv-1 Transmissionmentioning

confidence: 99%

“…However, MTCT has been observed in a small percentage of children (approximately 2.5–6.7%) exclusively fed infant formula [ 56 , 68 , 71 ]. This suggests the possibility of antenatal MTCT [ 54 ].…”

Section: Modes Of Htlv-1 Transmissionmentioning

confidence: 99%

How Can We Prevent Mother-to-Child Transmission of HTLV-1?

Itabashi¹,

Miyazawa

Uchimaru

2023

IJMS

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“…In Japan, HTLV-1 infected mothers are advised not to breastfeed or to do so only for less than 3 months ( 7 ). These recommendations are based on studies showing that avoidance of breastfeeding and exclusive formula feeding, short-term breastfeeding up to 3–6 months, or, in few studies, the freeze-thaw method reduce MTCT ( 19 , 87 , 88 ).…”

Section: How To Inhibit Oral Htlv-1 Transmission Despite Breastfeedin...mentioning

confidence: 99%

Milk Transmission of HTLV-1 and the Need for Innovative Prevention Strategies

Sebastian

Thoma-Kress

2022

Front. Med.

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Breastfeeding is recommended by the World Health Organization for at least 6 months up to 2 years of age, and breast milk protects against several diseases and infections. Intriguingly, few viruses are transmitted via breastfeeding including Human T-cell leukemia virus Type 1 (HTLV-1). HTLV-1 is a highly oncogenic yet neglected retrovirus, which primarily infects CD4+ T-cells in vivo and causes incurable diseases like HTLV-1-associated inflammatory conditions or Adult T-cell leukemia/lymphoma (ATLL) after lifelong viral persistence. Worldwide, at least 5–10 million people are HTLV-1-infected and most of them are unaware of their infection posing the risk of silent transmissions. HTLV-1 is transmitted via cell-containing body fluids such as blood products, semen, and breast milk, which constitutes the major route of mother-to-child transmission (MTCT). Risk of transmission increases with the duration of breastfeeding, however, abstinence from breastfeeding as it is recommended in some endemic countries is not an option in resource-limited settings or underrepresented areas and populations. Despite significant progress in understanding details of HTLV-1 cell-to-cell transmission, it is still not fully understood, which cells in which organs get infected via the oral route, how these cells get infected, how breast milk affects this route of infection and how to inhibit oral transmission despite breastfeeding, which is an urgent need especially in underrepresented areas of the world. Here, we review these questions and provide an outlook how future research could help to uncover prevention strategies that might ultimately allow infants to benefit from breastfeeding while reducing the risk of HTLV-1 transmission.

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“…The risk of transmission in an infant breastfed for less than 3 months is <2.5% (29,36). Some studies suggest the risk of MTCT with short term (≤3 month) breastfeeding is not significantly higher than that of infants exclusively formula fed (29,37). Infants breastfed for less than or equal to 6 months had a transmission risk of 3.9% compared with 20.3% for those breastfed for longer than 6 months (36).…”

Section: Mother-to-child Transmission Risk Factors and Preventionmentioning

confidence: 99%

A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm

et al. 2022

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Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5–10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. 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. 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. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. 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. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.

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Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention

Cited by 21 publications

References 116 publications

How Can We Prevent Mother-to-Child Transmission of HTLV-1?

How Can We Prevent Mother-to-Child Transmission of HTLV-1?

Milk Transmission of HTLV-1 and the Need for Innovative Prevention Strategies

A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm

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