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      Transmisión vertical del virus linfotrópico humano en el Hospital del Niño Manuel Ascensio Villarroel de Cochabamba estudio exploratorio Translated title: Vertical transmission of human lymphotropic virusat the Hospital del Niño Manuel Ascensio Villarroel the Cochabamba exploratory study

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          Abstract

          Resumen Los virus Linfotrópicos de células T humanas tipo I y II (HTLV) son retrovirus que se encuentran distribuidos a nivel mundial, se caracterizan por la infección de células TCD4+ y se asocian a dos tipos de enfermedades importantes como la leucemia/linfoma de células T adultas (ATLL) y la enfermedad neurológica, paraparesia espástica tropical (PET) o mielopatía. Una de las principales vías de transmisión es la denominada transmisión vertical, de madre a hijo a través de la lactancia materna, cuya tasa de transmisión es de 5,7 a 35,5 %. Objetivos: explorar la transmisión vertical del Virus HTLV en niños de 8 meses a 6 años de edad, que fueron atendidos en el Hospital del Niño Manuel Ascencio Villarroel, en el periodo 2020 -2021. Métodos: estudio cuantitativo, transversal, descriptivo, exploratorio. Resultados: de los 67 pacientes estudiados, una mayoría tiene origen étnico quechua, procedentes del área rural. Al estudio clínico, todos los pacientes presentan un estado nutricional conservado eutrófico (n=55), el promedio de lactancia materna de los mismos es de 17,2 meses. Al estudio laboratorial, un paciente dio positivo para HTLV por la técnica de ELISA, prueba realizada por duplicado en tiempos distintos, el cual corresponde al 1,5 % de los pacientes estudiados. Conclusiones: este estudio exploratorio demuestra fundamentalmente que este virus se encuentra circulando en nuestro medio, en el 1,5 % de la muestra estudiada, lo que hace necesario profundizar el estudio con un mayor número de muestras.

          Translated abstract

          Abstract The human T-cell lymphotropic virus type I and II (HTLV) are retroviruses that are distributed worldwide, are characterized by the infection of TCD4+ cells and are associated with two types of important diseases such as adult T-cell leukemia/lymphoma (ATLL) and the neurological disease, tropical spastic paraparesis (TSP) or myelopathy. One of the main routes of transmission is the so-called vertical transmission, from mother to child through breastfeeding, whose transmission rate is 5.7 to 35.5%. Objectives: to explore the vertical transmission of the HTLV Virus in children from 8 months to 6 years of age, who were treated at the Manuel Ascencio Villarroel Children's Hospital, in the period 2020 -2021. Methods: quantitative, cross-sectional, descriptive, exploratory study. Results: of the 67 patients studied, a large part has Quechua ethnic origin, coming from the rural area. Clinically, they present a preserved eutrophic nutritional status (n=55), with an average of 17.2 months of breastfeeding. Of the total number of patients, one tested positive for HTLV by the ELISA technique, which corresponds to 1.5% of the patients studied. Conclusions: this exploratory study basically demonstrates that this virus is circulating in our environment, in 1.5% of the sample studied, which makes it necessary to deepen the study with a greater number of samples.

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          Pathways of cell-cell transmission of HTLV-1

          The deltaretroviruses human T cell lymphotropic virus type 1 (HTLV-1) and human T cell lymphotropic virus type 2 (HTLV-2) have long been believed to differ from retroviruses in other genera by their mode of transmission. While other retroviruses were thought to primarily spread by producing cell-free particles that diffuse through extracellular fluids prior to binding to and infecting target cells, HTLV-1 and HTLV-2 were believed to transmit the virus solely by cell–cell interactions. This difference in transmission was believed to reflect the fact that, relative to other retroviruses, the cell-free virions produced by HTLV-infected cells are very poorly infectious. Since HTLV-1 and HTLV-2 are primarily found in T cells in the peripheral blood, spread of these viruses was believed to occur between infected and uninfected, T cells, although little was known about the cellular and viral proteins involved in this interaction. Recent studies have revealed that the method of transmission of HTLV is not unique: other retroviruses including human immunodeficiency virus (HIV) are also transmitted from cell-to-cell, and this method is dramatically more efficient than cell-free transmission. Moreover, cell–cell transmission of HTLV-1, as well as HIV, can occur following interactions between dendritic cells and T cells, as well as between T cells. Conversely, other studies have shown that cell-free HTLV-1 is not as poorly infectious as previously thought, since it is capable of infecting certain cell types. Here we summarize the recent insights about the mechanisms of cell–cell transmission of HTLV-1 and other retroviruses. We also review in vitro and in vivo studies of infection and discuss how these finding may relate to the spread of HTLV-1 between individuals.
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            Mother-to-Child Transmission of HTLV-1 Epidemiological Aspects, Mechanisms and Determinants of Mother-to-Child Transmission

            Human T-cell Lymphotropic Virus type 1 (HTLV-1) is a human retrovirus that infects at least 5–10 million people worldwide, and is the etiological agent of a lymphoproliferative malignancy; Adult T-cell Leukemia/Lymphoma (ATLL); and a chronic neuromyelopathy, HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP), as well as other inflammatory diseases such as infective dermatitis and uveitis. Besides sexual intercourse and intravenous transmission, HTLV-1 can also be transmitted from infected mother to child during prolonged breastfeeding. Some characteristics that are linked to mother-to-child transmission (MTCT) of HTLV-1, such as the role of proviral load, antibody titer of the infected mother, and duration of breastfeeding, have been elucidated; however, most of the mechanisms underlying HTLV-1 transmission during breast feeding remain largely unknown, such as the sites of infection and cellular targets as well as the role of milk factors. The present review focuses on the latest findings and current opinions and perspectives on MTCT of HTLV-1.
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              Mother-to-Child Transmission of Human T-Cell Lymphotropic Viruses-1/2: What We Know, and What Are the Gaps in Understanding and Preventing This Route of Infection.

              Although human T-cell lymphotropic viruses (HTLV-1/2) were described over 30 years ago, they are relatively unknown to the public and even to healthcare personnel. Although HTLV-1 is associated with severe illnesses, these occur in only approximately 10% of infected individuals, which may explain the lack of public knowledge about them. However, cohort studies are showing that a myriad of other disease manifestations may trouble infected individuals and cause higher expenditures with healthcare. Testing donated blood for HTLV-1/2 started soon after reliable tests were developed, but unfortunately testing is not available for women during prenatal care. Vertical transmission can occur before or after birth of the child. Before birth, it occurs transplacentally or by transfer of virus during cesarean delivery, but these routes of infection are rare. After childbirth, viral transmission occurs during breastfeeding and increases with longer breastfeeding and high maternal proviral load. Unlike the human immunodeficiency virus types 1 and 2, HTLV is transmitted primarily through breastfeeding and not transplacentally or during delivery. In this study, we review what is currently known about HTLV maternal transmission, its prevention, and the gaps still present in the understanding of this process.
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                Author and article information

                Journal
                gmb
                Gaceta Médica Boliviana
                Gac Med Bol
                Facultad de Medicina de la Universidad Mayor de San Simón (Cochabamba, , Bolivia )
                1012-2966
                2227-3662
                2023
                : 46
                : 2
                : 58-62
                Affiliations
                [1] orgnameResidente especialidad pediatría
                [2] Cochabamba orgnameUniversidad Mayor de San Simón orgdiv1Facultad de Medicina orgdiv2CUMETROP- IIBISMED Bolivia
                [3] Cochabamba orgnameUniversidad Mayor de San Simón orgdiv1Facultad de Medicina orgdiv2LABIMED Bolivia
                [4] Cochabamba orgnameUniversidad Mayor de San Simón orgdiv1Facultad de Medicina Bolivia
                Article
                S1012-29662023000200058 S1012-2966(23)04600200058
                10.47993/gmb.v46i2.557
                7845fbdd-eede-48fb-8a38-579e5266d264

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 February 2023
                : 02 July 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 5
                Product

                SciELO Bolivia

                Categories
                Artículo Original

                epidemiology,epidemiología,prevalencia,HTLV,prevalence
                epidemiology, epidemiología, prevalencia, HTLV, prevalence

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