MOTHER-TO-CHILD TRANSMISSION OF HUMAN T-LYMPHOTROPIC VIRUS TYPE-II

Objective: To determine the frequency of mother-to-child transmission of human T-lymphotropic virus type II (HTLV-I) and to explore its association with breast-feeding. Design: Prospective study of children born to a cohort of HTLV-II-infected pregnant women and a cross-sectional study of older siblings of these children. Methods: Maternal sera were screened with an HTLV-I enzyme immunoassay that detects antibody to both HTLV-I and HTLV-II. Confirmatory serologic testing and viral typing were performed by Western blot, radioimmunoprecipitation assay, enzyme immunoassay with HTLV type-specific proteins, and polymerase chain reaction (PCR) analysis of DNA from peripheral blood mononuclear cells. The presence of HTLV was evaluated in children by serial serologic and PCR testing. Molecular analysis of PCR products from infected mother-child pairs was performed by means of restriction fragment length polymorphism of HTLV-II long-terminal repeated sequences. Results: Twenty nine HTLV-II-infected women were identified, and these 29 women had 30 pregnancies during the study, Of 28 live infants born to infected women, 19 were examined and none was infected with HTLV-II. Sixteen older children less than 10 years of age who were born previously to the infected women were also examined; two were infected with HTLV-IL. One infected child was breast fed for 2 months and the second was not breast fed. The viral patterns of restriction fragment length polymorphism in the two infected children were distinct, but the viral pattern in each chid was identical to that of her mother's virus, suggesting mother-to-child transmission. Overall, among examined children, 1 of 7 breast-fed children (14%-95% confidence interval: 0, 40) and 1 of 28 children who were not breast fed (3.6%; 95% confidence interval: 0, 10) were infected with HTLV-II. Conclusion: Mother-to-child transmission of HTLV-II occurs both with and without breast-feeding and at rates similar to those of HTLV-L. We believe that this is the first demonstration of mother-to-child transmission of HTLV-II in the absence of breast-feeding.