HTLV-1, a neglected disease among breastfeeding women from endemic areas: a national survey of knowledge and screening practices in France

Abstract

Background

Screening of some infectious diseases is consistently recommended during pregnancy in France. Although Human T lymphotropic virus type 1 (HTLV-1) infection is a contraindication for breastfeeding, its screening is not routinely recommended as it is uncommon in a native mainland French population. However, HTLV-1 screening should be recommended among women from endemic countries. This study aims to evaluate HTLV-1 knowledge and screening practices of French healthcare professionals among pregnant women.

Methods

A French national professional practice evaluation study was conducted in 2022. An electronic questionnaire was distributed to midwives, gynecologists, and general practitioners in partnership with medical societies, and hospitals.

Results

A total of 936 participants were included, 75.4% (n=706) of whom were midwives and 21.8% were gynecologists (n=204). Among the participants, 62.1% had outpatient practice and 71.1% had never received previous specific training in obstetric infectious diseases. Only 27.5% of participants reported HTLV-1 as a contraindication to breastfeeding. Of these, a significant proportion had prior specific training in obstetric infectious diseases and practiced in the Paris region or endemic French overseas territories. Knowledge of countries that should lead to HTLV-1 screening was limited and appeared to vary among participants.

Conclusion

This national practice evaluation study highlighted the widespread lack of awareness of the issue of HTLV-1 infection. Further studies are needed to assess HTLV-1 seroprevalence in pregnant women (in France or similar European countries), and to evaluate relevance of targeted screening and psychological impact of a positive diagnosis.