title: Frequent HTLV-1 infection in the offspring of Peruvian women with HTLV-1-associated myelopathy/tropical spastic paraparesis or strongyloidiasis.
abstract: OBJECTIVE
  To describe the frequency of HTLV-1 infection among offspring of mothers who had presented with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), strongyloidiasis, or asymptomatic HTLV-1 infection, and to identify factors associated with HTLV-1 infection.
  
  
  METHODS
  In a descriptive study, records were reviewed of HTLV-1-positive women and their offspring who had been tested for HTLV infection at a public hospital in Lima, Peru, from 1989 to 2003. Sons and daughters of women who had presented with strongyloidiasis, HAM/TSP, or asymptomatic infection were eligible for this study.
  
  
  RESULTS
  Three hundred seventy subjects were included: 279 were the offspring of 104 mothers presenting with HAM/TSP, 58 were the offspring of 22 mothers with strongyloidiasis, and 33 were the offspring of 26 asymptomatic mothers. Mean age of the offspring at the time of testing was 26 years (standard deviation 12). Nineteen percent of the offspring tested positive for HTLV-1: 6% (2/33) of those with asymptomatic mothers, 19% (52/279) among the offspring of mothers with HAM/TSP, and 31% (18/58) among the offspring of mothers presenting with strongyloidiasis On multiple logistic regression analysis, three factors were significantly associated with HTLV-1: (a) duration of breast-feeding (odds ratio [OR] = 15.1; [4.2-54.1] for 12 to 24 months versus less than 6 months breast-feeding); (b) clinical condition of the mother (OR = 8.3 [1.0-65.3] for HAM/TSP and OR = 11.5 [1.4-98.4] for strongyloidiasis in comparison with offspring of asymptomatic mothers); and (c) transfusion history (OR = 5.5 [2.0-15.2]).
  
  
  CONCLUSIONS
  In addition to known risk factors for HTLV-1 transmission (duration of breast-feeding and history of blood transfusion), maternal HAM/TSP and strongyloidiasis were associated with seropositivity among offspring of HTLV-1-infected mothers.
authors: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Avenida Honorio Delgado 430, Lima, Peru. egh@upch.edu.pe
authors: Eduardo
authors: E
authors: Gotuzzo
authors: Joel
authors: J
authors: Moody
authors: Kristien
authors: K
authors: Verdonck
authors: Miguel M
authors: MM
authors: Cabada
authors: Elsa
authors: E
authors: González
authors: Sonia
authors: S
authors: Van Dooren
authors: Anne-Mieke
authors: AM
authors: Vandamme
authors: Angélica
authors: A
authors: Terashima
authors: Sten H
authors: SH
authors: Vermund
mesh_terms: D000328:Adult; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D005260:Female; D015490:HTLV-I Infections / Q000208:ethnology* / Q000635:transmission*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000208:ethnology*; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D013322:Strongyloidiasis / Q000208:ethnology*