PEDIATRICS Vol. 86 No. 1 July 1990, pp. 11-17
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Prevention of Mother-to-Child Transmission of Human T-Lymphotropic Virus Type-I

Yoshiro Tsuji MD, PhD1, Hiroshi Doi MD1, Tooru Yamabe MD, PhD1, Tadayuki Ishimaru MD, PhD1, Tsutomu Miyamoto MD, PhD1, and Shigeo Hino MD, PhD1

1 From the Departments of Pediatrics, Obstetrics and Gynecology, and Bacteriology, Nagasaki University School of Medicine, Nagasaki, Japan

Human T-cell lymphotropic virus type I (HTLV-I), an etiologic human retrovirus of adult T-cell leukemia/lymphoma (ATLL), causes approximately 60 new cases of ATLL each year in Nagasaki Prefecture; essentially all cases are fatal, and they account for approximately 0.5% of total deaths in the area. The estimated life risk for an HTLV-I carrier to develop ATLL is approximately 5%. The major transmission pathway of HTLV-I peculiarly endemic in the Nagasaki Prefecture was studied. The prevalence of HTLV-I infection in children of carrier mothers (21%) was significantly higher than that in children in the general population in the area (1%), and more than 85% of mothers of carrier children were carriers. The breast milk of carrier mothers contained HTLV-I-infected cells and was infectious for marmoset via oral administration. A retrospective survey of children of carrier mothers showed that the prevalence of carrier children of carrier mothers was 17 (39%) of 44 and 0 (0%) of 10 when they were given breast milk only or formula only, respectively. These data provide a powerful basis for devising an intervention measure to block the endemic cycle of HTLV-I; ie, if carrier mothers refrain from breast-feeding, the incidence of ATLL will be significantly reduced some 50 years later.

Key Words: human T-lymphotropic virus • human T-cell leukemia virus • breast milk • mother-to-child transmission

Submitted on January 19, 1989
Accepted on August 22, 1989




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