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
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
Affiliations
José-Manuel Ramos-Rincón
Clinical Medicine Department, Miguel Hernández University of Elche & General University Hospital of Alicante, 03010 Alicante, Spain
Sonia Ortiz-Martínez
Medical Practice El Ballestero, Health Service of Castilla La Mancha, 02614 Albacete, Spain
María-Esteyner Vásquez-Chasnamote
Natural Resources Research Center, Peruvian Amazon National University, Iquitos 16001, Peru
Eva de-Miguel-Balsa
Clinical Medicine Department, Miguel Hernández University of Elche & General University Hospital of Elche, 03002 Alicante, Spain
Olga-Nohelia Gamboa-Paredes
Medical Department, Amazon Rainforest Civil Association, Iquitos 16001, Peru
Michael-John Talledo-Albujar
Virology Unit, Institute of Tropical Medicine ‘Alexander von Humboldt’, Peruvian University Cayetano Heredia, Lima 15102, Peru
Giovanni López-Campana
Virology Unit, Institute of Tropical Medicine ‘Alexander von Humboldt’, Peruvian University Cayetano Heredia, Lima 15102, Peru
Juan Carlos Celis-Salinas
Infectious Diseases and Tropical Medicine Service, Regional Hospital of Loreto & National University of the Peruvian Amazon, Iquitos 1600, Peru
Laura Prieto-Pérez
Infectious Diseases Division, University Hospital Foundation Jiménez Díaz & Autonomous University of Madrid, 28040 Madrid, Spain
Miguel Górgolas-Hernández
Infectious Diseases Division, University Hospital Foundation Jiménez Díaz & Autonomous University of Madrid, 28040 Madrid, Spain
Martin Casapía-Morales
Infectious Diseases and Tropical Medicine Service, Regional Hospital of Loreto & National University of the Peruvian Amazon & Medical Department, Amazon Rainforest Civil Association, Iquitos 16001, Peru
Background. 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. (2) Methods. 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. (3) Results. 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]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, 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 HTLV 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%). (4) Conclusion. 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.
