[Slow virus infection in the field of obstetrics and gynecology--with special reference to HBV, HTLV-1 and HCV].
The slow virus infection (SVI) established by Gajdusek DC in 1964 has been known to involve not only Kuru or Creutzfeldt-Jakob disease but also hepatitis B virus (HBV) infection and very recently human T-cell lymphotropic virus type 1 (HTLV-1) or hepatitis C virus (HCV) infection. These all viruses potentially develop serious, irreversible disease, ie, hepatoma or adult T-cell leukemia, after long latent periods. HBV, HTLV-1 and HCV can be transmitted vertically from carrier mothers to their offspring, and therefore, are serious SVIs in the field of obstetrics. HB immunoglobulin (HBIG) and HB vaccine have been used clinically for the prevention of HBV vertical transmission (VT) under the guidance of the Ministry of Public Welfare in Japan. This nation-wide trial has much contributed to reducing the development of new carriers. However, the protocol recommended by the Ministry is a bit noncost-effective and troublesome for the patients and physicians. To solve the problem we newly designed our own regimen based on the natural history of HBV VT, the neonatal immune response to the recombinant vaccine and cost-effectiveness, and compared it with the Ministry one. It is not doubt that breast feeding is the most important route for HTLV-1 VT. However, other infectious routes, ie, intrauterine or transvaginal infection, have been recently worth noticing.(ABSTRACT TRUNCATED AT 250 WORDS)
Inaba
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Department of Obstetrics and Gynecology, Faculty of Medicine, University of Chiba.
D001942:Breast Feeding; D016000:Cluster Analysis; D005260:Female; D015490:HTLV-I Infections / Q000635:transmission*; D006509:Hepatitis B / Q000517:prevention & control*; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011446:Prospective Studies; D012897:Slow Virus Diseases