Prevalence and first detection of HTLV-2 in a pregnant woman in rural Brazil

Abstract

Human T-lymphotropic virus (HTLV) is a retrovirus with two subtypes, HTLV-1 and HTLV-2. HTLV-1 is linked to severe diseases such as adult T-cell leukemia/lymphoma (ATLL) and HTLV-associated myelopathy, while HTLV-2 is considered less pathogenic but can cause fibromyalgia, hairy cell leukemia, and neurological disorders. Although HTLV-2 is less prevalent than HTLV-1, it is common in specific populations, such as indigenous groups and injection drug users. In Brazil, an estimated 200,000–250,000 people are infected with HTLV-2, mostly in the North, yet data on its prevalence in pregnant women remain scarce. This study aimed to estimate the prevalence of HTLV-1/2 among pregnant women in Pernambuco, revealing a 0.49 % prevalence rate, which exceeds that reported in other regions of Brazil. Notably, one case of HTLV-2 was identified in a non-indigenous pregnant woman, suggesting that HTLV-2 may be more widespread than previously recognized. Despite the integration of HTLV screening into routine prenatal care, a major gap exists in the awareness of HTLV-2 among healthcare professionals and the general population, hindering effective prevention and management. The study highlights the need for expanded screening, particularly in rural areas, and underscores the importance of addressing gaps in sexual health education and prevention.