PDF(Pubmed)
Abstract：
BackgroundHuman T-cell lymphotropic virus type 1 (HTLV-1) is a neglected virus that can cause severe disease and be transmitted from mother to child through breastfeeding. Avoidance of breastfeeding prevents 80% of vertical transmission. The United Kingdom (UK) is currently assessing whether HTLV-1-targeted antenatal screening should be implemented.AimWe aimed to assess the impact and cost-effectiveness of a targeted programme to prevent HTLV-1 vertical transmission in England and Wales.MethodsWe estimated the number of pregnant women who have high risk of HTLV-1 infection based on their or their partner\'s country of birth. With data from 2021, we used a mathematical model to assess cost-effectiveness of HTLV-1 antenatal screening. We also estimated the annual number of infant infections and the number that could be prevented with screening and intervention.ResultsWe estimate that ca 99,000 pregnant women in England and Wales have high risk of HTLV-1 infection. In the absence of screening, 74 (range: 25-211) HTLV-1 infections in infants would be expected to occur every year in England and Wales. Implementation of targeted screening would prevent 58 (range: 19-164) infant infections annually. The intervention is effective (incremental 0.00333 quality-adjusted life years (QALY)) and cost-saving (GBP -57.56 (EUR -66.85)).ConclusionOur findings support implementation of HTLV-1 targeted antenatal screening to reduce vertical transmission from mothers to infants in the UK.
摘要：
背景人类嗜T淋巴细胞病毒1型（HTLV-1）是一种被忽视的病毒，可引起严重的疾病，并通过母乳喂养从母婴传播。避免母乳喂养可以防止80％的垂直传播。英国（UK）目前正在评估是否应实施HTLV-1针对性的产前筛查。AimWe旨在评估有针对性的计划的影响和成本效益，以防止英格兰和威尔士的HTLV-1垂直传播。方法我们根据其或其伴侣的出生国估计HTLV-1感染高风险孕妇的数量。根据2021年的数据，我们使用数学模型来评估HTLV-1产前筛查的成本效益。我们还估计了每年婴儿感染的数量以及通过筛查和干预可以预防的数量。结果我们估计英格兰和威尔士约有99,000名孕妇感染HTLV-1的风险很高。在没有筛查的情况下，74（范围：25-211）婴儿中的HTLV-1感染预计每年在英格兰和威尔士发生。实施有针对性的筛查每年可预防58例（范围：19-164）婴儿感染。干预措施是有效的（增量0.00333质量调整生命年（QALY））和节省成本（GBP-57.56（EUR-66.85））。结论我们的研究结果支持在英国实施HTLV-1针对性的产前筛查，以减少从母亲到婴儿的垂直传播。
