Brazilian health authorities have issued new clinical guidelines to prevent the transmission of Human T-lymphotropic virus (HTLV-1/2) from mothers to their children, a move addressing a important public health concern in a country with a high prevalence of the virus. The updated recommendations, released as a technical note, focus on improved testing protocols during pregnancy and tailored management strategies throughout the perinatal period. While HTLV often remains asymptomatic, the potential for serious long-term health consequences-including leukemia and neurological disorders-underscores the importance of these new preventative measures [[1]].
Brazilian health officials have issued new guidance aimed at preventing the mother-to-child transmission of Human T-lymphotropic virus (HTLV-1/2), a sexually transmitted infection that can also spread through blood contact and during pregnancy, childbirth, and, most significantly, breastfeeding. The recommendations, published in a new technical note, outline testing protocols for pregnant women, clinical management strategies, and guidance on delivery methods and infant feeding practices to reduce vertical transmission within the country’s public health system.
Developed by the Secretariat for Health Surveillance and Environment (SVSA) and the Secretariat for Primary Health Care (Saps), the technical note provides specific directives for healthcare providers and administrators regarding care during pregnancy and follow-up monitoring of infants exposed to the virus. This guidance is particularly important as HTLV infection often remains asymptomatic for years, yet carries the risk of serious complications later in life.
An estimated 800,000 people in Brazil are living with HTLV-1, according to the Ministry of Health. While the infection is chronic, most individuals experience no immediate or severe symptoms. However, when clinical manifestations do occur, HTLV can be linked to chronic inflammatory diseases and severe conditions such as Adult T-cell Leukemia/Lymphoma (ATLL) and HTLV-1-associated myelopathy (HAM).
The technical note was created in collaboration with the HTLV Technical Advisory Committee, comprised of specialists and representatives from civil society. It emphasizes the importance of HTLV testing for all pregnant women whenever screening and confirmatory tests are available. Testing is recommended during the first trimester, ideally at the first prenatal appointment.
Beyond testing, the guidance details specific recommendations regarding delivery methods and breastfeeding, which are considered key strategies for minimizing vertical transmission of HTLV. These recommendations are designed to support informed clinical decision-making and enhance the quality of care provided to pregnant women and their potentially exposed infants.
“This technical note is an important step forward for public health,” said Pâmela Gaspar, Coordinator-General of Surveillance of Sexually Transmitted Infections. “It provides a framework for operationalizing HTLV diagnosis and implementing management strategies to prevent vertical transmission. Our focus is to ensure welcoming and comprehensive care for pregnant women with HTLV and their exposed children.”
Eliminating vertical transmission of HTLV as a public health problem by 2030 is a national priority in Brazil and is integrated into the goals of the Healthy Brazil Program, Gaspar added.
Since April 2024, HTLV-1/2 infection has been classified as a mandatory reportable condition in adults, pregnant women, postpartum women, and children at risk of vertical transmission. Reporting must be completed via the specific form in the e-SUS Sinan system following diagnosis. Children exposed to HTLV require ongoing monitoring in Specialized Care Services, in coordination with Primary Health Care.
Agência de Notícias da Aids
