HTLV infection among pregnant women attending a viral hepatitis referral center in Rio de Janeiro, Brazil

Abstract

Human T-cell lymphotropic virus (HTLV) remains a neglected infection worldwide, despite its potential for severe disease and vertical transmission. In Brazil, the burden of HTLV infection among pregnant remains poorly understood, underscoring the need for updated epidemiological data to guide elimination strategies. This study aimed to estimate the prevalence and socio-epidemiological profile of HTLV infection in pregnant receiving care at a referral center in Rio de Janeiro, Brazil. We conducted a mixed (retrospective and prospective) cohort study of 403 pregnant (409 gestational events) referred between 2016 and 2024. All participants were screened for HTLV-1/2 using chemiluminescent immunoassay and confirmed by Western blot. Sociodemographic and clinical data were collected from medical records. HTLV testing was performed in 305 pregnant, with four confirmed infections (prevalence of 1.31% [CI 0,36% – 3,32%]). Three cases (75%) were HTLV-1 and one (25%) HTLV-2. Most women self-identified as mixed race (75%) and had low educational attainment (75%). Coinfections with HBV, HCV, and HIV were detected in 50%, 50%, and 25% of cases, respectively. HTLV prevalence among pregnant was higher than some previous regional estimates, underscoring the need for timely diagnosis to mitigate the risk of new infections. These findings underscore the need for universal antenatal screening, health education, and targeted public health interventions to prevent vertical transmission in Brazil.