Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru

• Main Authors: José-Manuel Ramos-Rincón, Sonia Ortiz-Martínez, María-Esteyner Vásquez-Chasnamote, Eva de-Miguel-Balsa, Olga-Nohelia Gamboa-Paredes, Michael-John Talledo-Albujar, Giovanni López-Campana, Juan Carlos Celis-Salinas, Laura Prieto-Pérez, Miguel Górgolas-Hernández, Martin Casapía-Morales
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: Pathogens
• Subjects: HTLV; prevalence; pregnant women; Peru; Amazon; systematic review
• Online Access: https://www.mdpi.com/2076-0817/10/3/260

<strong>Background</strong>.<strong> </strong>Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. <strong>(2) Methods</strong>. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. <strong>(3) Results</strong>. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; <em>p</em> = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for <em>Strongyloides</em>,<em> </em>but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of <em>HTLV </em>infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). <strong>(4) Conclusion</strong>. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.