HTLV infection and its implication in gynaecology and obstetrics.
BACKGROUND
Worldwide, 20-30 million people are estimated to be infected with HTLV. HTLV-1 is endemic in Western Africa and Southern Japan, whereas HTLV-2 is considered to be spread among native American people.


METHODS
The impact of HTLV in gynaecology and obstetrics is being reviewed. Search strategy and selection criteria for identifying relevant data were performed by searching Medline, Current Contents, Web of Science, Embase and references from relevant articles. English and German gynaecological and infectious diseases textbooks as well as national and international guidelines and recommendations were also reviewed.


RESULTS
Transmission may occur by sexual intercourse or cellular blood products. Although materno-fetal transmission is debated, transmission through maternal breast milk has been confirmed. An HTLV-infection can lead to adult T-cell leukaemia (ATL) or cumulative opportunistic and neurological disorders that can occur with varying degrees of severity. Diagnosis can be done by antibody detection via the use of ELISA and western blot analysis as well as PCR diagnosis.


CONCLUSIONS
Due to inadequate treatment options and the lack of an effective vaccination, prevention is currently only possible by restricting transmission, including the usage of condoms during sexual intercourse or avoiding breastfeeding in HTLV-seropositive mothers. If, due to socio-economic reasons, breastfeeding cannot be avoided, short-term breastfeeding for a maximum of up to 6 months is suggested.
Mylonas
Ioannis
I
First Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University Munich, 80337 Munich, Germany. ioannis.mylonas@med.uni-muenchen.de
Brüning
Ansgar
A
Kainer
Franz
F
Friese
Klaus
K
D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects; D006800:Deltaretrovirus Infections / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D015367:Human T-lymphotropic virus 2 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology*