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Stopping breastfeeding to prevent vertical transmission of HTLV-1 in resource-poor settings: beneficial or harmful?

Archives of Gynecology and Obstetrics
Publication Date
DOI: 10.1007/s00404-011-2211-4
  • Letter To The Editor
  • Ecology
  • Economics
  • Medicine


Arch Gynecol Obstet (2012) 286:255–256 DOI 10.1007/s00404-011-2211-4 LETTER TO THE EDITOR Stopping breastfeeding to prevent vertical transmission of HTLV-1 in resource-poor settings: beneWcial or harmful? Carla van Tienen · Marianne Jakobsen · Maarten Schim van der LoeV Received: 6 September 2011 / Accepted: 31 December 2011 / Published online: 7 January 2012 © The Author(s) 2012. This article is published with open access at In a recent issue of this journal Mylonas et al. [1] reviewed human T-lymphotropic virus type 1 (HTLV-1) infection and its implications in gynecology and obstetrics. Although HTLV-1 is rare in many populations, it occurs worldwide and is associated with a substantial disease burden and a high risk of vertical transmission. The authors provide rec- ommendations for prevention of sexual and vertical trans- mission of HTLV-1. One of the recommendations is the following: ‘If stopping breastfeeding is not possible, for example due to socio-economical circumstances, short- term breastfeeding for 3 to a maximum of 6 months should be advocated’. The recommendation in the review is based on two studies from Japan showing reductions of vertical transmission by limiting or avoiding breastfeeding. To our knowledge, no international guidelines exist (e.g. from the WHO or CDC) on breastfeeding and HTLV-1 prevention in resource-poor, developing countries. Therefore, it is impor- tant to carefully take into account the risks versus the bene- Wts of advocating short-term breastfeeding in developing countries. Various studies have shown that prolonged breastfeed- ing is associated with an increased risk of HTLV-1 trans- mission and avoiding breastfeeding can lead to a dramatic reduction in transmission [2]. A high maternal proviral load in combination with waning antibodies in the child leads to an increased risk of HTLV-1 transmission, espe- cially after 6–12 months after birth [3]. However, the key question is whether the beneWts of avoiding HTLV-1 infect

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