title: HTLV-1 in pregnant women from the Southern Bahia, Brazil: a neglected condition despite the high prevalence.
abstract: BACKGROUND
  As the most frequent pathway of vertical transmission of HTLV-1 is breast-feeding, and considering the higher prevalence in women, it is very important to perform screening examinations for anti-HTLV-1 antibodies as part of routine prenatal care. So far, no studies of HTLV-1 seroprevalence in pregnant women in the Southern region of Bahia, Brazil, have been described.
  
  
  METHODS
  Pregnant women were selected at the two regional reference centers for health care from Southern Bahia. A total of 2766 pregnant women attending the antenatal unit between November 2008 and May 2010 have been analyzed. An extra blood sample was drawn during their routine antenatal testing. A standardized questionnaire was applied and all positive plasma samples were tested by ELISA and were confirmed by Western Blot and PCR. Besides that, positive women were contacted and visited. The family members that were present during the visit were asked to be serologically screened to the virus. A prospective study was also carried out and newborns were followed up to two years for evaluation of vertical transmission.
  
  
  RESULTS
  HTLV prevalence was 1.05% (CI 95%: 0.70-1.50). There was no association of HTLV-1 infection with age, education, income and ethnic differences. The association with marital status was borderline (OR = 7.99; 95% CI 1.07-59.3; p = 0.042). In addition, 43 family members of the HTLV-1 seropositive women have been analyzed and specific reactivity was observed in 32.56%, including two children from previous pregnancy.
  
  
  CONCLUSIONS
  It is very important to emphasize that the lack of HTLV-1 screening in pregnant women can promote HTLV transmission especially in endemic areas. HTLV screening in this vulnerable population and the promotion of bottle-feeding for children of seropositive mothers could be important cost-effective methods to limit the vertical transmission. Besides that, our data reinforce the need to establish strategies of active surveillance in household and family contacts as important epidemiological surveillance actions for the early detection of virus infection and the prevention of transmission by sexual or and parenteral contact.
authors: Marco Antônio Gomes
authors: MA
authors: Mello
authors: Aline Ferreira
authors: AF
authors: da Conceição
authors: Sandra Mara Bispo
authors: SM
authors: Sousa
authors: Luiz Carlos
authors: LC
authors: Alcântara
authors: Lauro Juliano
authors: LJ
authors: Marin
authors: Mônica
authors: M
authors: Regina da Silva Raiol
authors: Ney
authors: N
authors: Boa-Sorte
authors: Lucas Pereira Souza
authors: LP
authors: Santos
authors: Maria da Conceição Chagas
authors: Mda C
authors: de Almeida
authors: Tâmara Coutinho
authors: TC
authors: Galvão
authors: Raquel Gois
authors: RG
authors: Bastos
authors: Noilson
authors: N
authors: Lázaro
authors: Bernardo
authors: B
authors: Galvão-Castro
authors: Universidade Estadual de Santa Cruz, Rodovia Ilhéus-Itabuna Km 16-Salobrinho, Ilhéus, Bahia, Brazil. sandragadelha@hotmail.com.
authors: Sandra Rocha
authors: SR
authors: Gadelha
mesh_terms: D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015490:HTLV-I Infections / Q000453:epidemiology* / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011795:Surveys and Questionnaires; D055815:Young Adult