Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
HUMAN DISEASES RELATED WITH HTLV-1: PATHOGENESIS AND PREVENTION
Serono Symp Publ Raven Press; 59:47-62 1989. Unique Identifier : AIDSLINE ICDB/90660595 Hino S; Dept. of Bacteriology, Nagasaki Univ. Sch. of Medicine, Nagasaki; 852, Japan
Abstract:
In 1977, a distinct form of T-cell leukemia, adult T-cell leukemia (ATL), was reported in Japan. A human retrovirus, human T-lymphotropic virus (HTLV)-1, is found in all patients with ATL. ATL in Japan is reviewed and preliminary results of application of a preventive strategy are described. Topics include characteristics of ATL; HTLV-1-associated myelopathy; characteristics of HTLV-1 infection; geographic distribution of HTLV-1, particularly in Japan; age distribution of HTLV-1 carriers; cell-to-cell infection; routes of HTLV-1 infection (blood transfusion, sexual transmission, maternal-infant infections, and laboratory evidence for human milk-borne transmission of HTLV-1); and retrospective and prospective analyses of routes of HTLV-1 transmission. Epidemiologic analyses, laboratory studies of human milk, and infection studies involving marmosets strongly suggested that HTLV-1 is transmitted from infected mothers to infants via breast milk. Of 83 pairs of mothers and children in which the mother was a carrier, 14/43 children nourished mostly with breast milk were infected, whereas 0/10 children who were never breast fed were infected. Three of 30 children who were partially breast fed initially or were withdrawn prematurely from breast feeding were infected. A program of prevention was begun in which carrier mothers were discouraged from breast feeding, and their children were monitored for the presence of HTLV-1. For the first 100 cases, none of the children who were formula-fed were antibody-positive. Since the beginning of the prevention program, 3% of the children ultimately have become antibody-positive for HTLV-1. Apparently the present intervention program is not totally preventive, but it does sharply reduce the rate of infection. The program is simple and safe in developed countries, but is not recommended for developing countries where drinking water is contaminated and appropriate concentration of the compound milk cannot be assured. Compound feeding under these conditions would lead to much more direct and serious infant health problems than ATL. (50 Refs)
Keywords: Adolescence Adult Carrier State Child Child, Preschool Female Human HTLV-I/*PATHOGENICITY HTLV-I Infections/PREVENTION & CONTROL/*TRANSMISSION Infant Infant, Newborn Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/PREVENTION & CONTROL/*TRANSMISSION Maternal-Fetal Exchange Pregnancy Pregnancy Complications, Infectious/ETIOLOGY Prospective Studies Retrospective Studies Risk Factors JOURNAL ARTICLE REVIEW, TUTORIAL REVIEW 900530
M9051005
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
