关键词: Antenatal screening Breastfeeding HTLV-1 Latin America Pregnant women Vertical transmission

Mesh : Humans Pregnancy Female HTLV-I Infections / epidemiology HTLV-II Infections / epidemiology Prevalence Caribbean Region / epidemiology South America / epidemiology Human T-lymphotropic virus 1 / immunology Pregnancy Complications, Infectious / epidemiology virology Human T-lymphotropic virus 2 / immunology Central America / epidemiology

来  源:   DOI:10.1016/j.ijid.2024.107018

Abstract:
BACKGROUND: Human T-lymphotropic viruses (HTLV)-1 infection is endemic in many countries of Central and South America and Caribbean (CSA&C). Neither screening nor surveillance programs exist for HTLV-1/2 infection among pregnant women in this region. Neither in Western nations with large migrant flows from HTLV-1/2 endemic regions.
METHODS: Systematic review and meta-analysis of the prevalence of HTLV-1/2 infection among CSA&C pregnant women. We included studies searching EMBASE, PubMed/MEDLINE, Scopus, and Web of Science from inception to February 15, 2023. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines.
RESULTS: We identified a total of 620 studies. Only 41 were finally included in the meta-analysis. Most studies (61.0%) were from Brazil and Peru (14.6%). The total number of participants was 343,707. The pooled prevalence of HTLV-1/2 infection among CSA&C pregnant women was 1.30% (95% CI: 0.96-1.69) using anti-HTLV-1/2 antibody screening tests. There was a high heterogeneity (I2 = 98.6%). Confirmatory tests gave an HTLV-1 infection rate of 1.02% (95% CI: 0.75-1.33).
CONCLUSIONS: The prevalence of HTLV-1/2 infection among CSA&C pregnant women is 1.3%, most cases being HTLV-1. This rate is greater than for other microbial agents regularly checked as part of antenatal screening (such as HIV, hepatitis B, or syphilis). Thus, HTLV-1/2 antenatal testing should be mandatory among CSA&C pregnant women everywhere.
摘要:
背景:人类嗜T淋巴细胞病毒(HTLV)-1感染在中美洲,南美洲和加勒比(CSA&C)的许多国家都是地方性的。该地区孕妇中既没有HTLV-1/2感染的筛查计划,也没有监测计划。在拥有大量移民的西方国家中,HTLV-1/2流行地区都没有。
方法:CSA&C孕妇HTLV-1/2感染率的系统评价和荟萃分析。我们纳入了搜索EMBASE的研究,PubMed/MEDLINE,Scopus,和WebofScience从成立到2023年2月15日。本系统评价遵循系统评价和荟萃分析报告指南的首选报告项目。
结果:我们共确定了620项研究。最终只有41人被纳入荟萃分析。大多数研究(61.0%)来自巴西和秘鲁(14.6%)。参与者总数为343,707。使用抗HTLV-1/2抗体筛查试验,CSA&C孕妇中HTLV-1/2感染的合并患病率为1.30%(95%CI:0.96-1.69)。存在高度异质性(I2=98.6%)。证实试验的HTLV-1感染率为1.02%(95%CI:0.75-1.33)。
结论:CSA&C孕妇中HTLV-1/2感染率为1.3%,大多数病例是HTLV-1。这一比率高于作为产前筛查一部分定期检查的其他微生物制剂(如艾滋病毒,乙型肝炎,或梅毒)。因此,HTLV-1/2产前检查应该是CSA&C孕妇的强制性检查。
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