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Encinas B, Benito R, Rojo S, Reina G, Montiel N, Aguilera A, Eiros JM, García-Costa J, Ortega D, Arco I, Hernánez-Batancor A, Soriano V, de Mendoza C. Human T-lymphotropic virus-1 infection among Latin American pregnant women living in Spain. IJID Reg 2024; 10:146-149. [PMID: 38304758 PMCID: PMC10831283 DOI: 10.1016/j.ijregi.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
Objectives Human T-lymphotropic virus (HTLV) antenatal screening is not mandatory in Spain. Surveys conducted decades ago reported HTLV-1 seroprevalence rates of 0.2% among foreign pregnant women in Spain. The migrant flow to Spain from HTLV-1 endemic regions in Latin America and sub-Saharan Africa has increased during the last decade. Currently, 25% of pregnant women in Spain are foreigners. Methods From January 2021 to October 2023 a cross-sectional study was carried out in all consecutive pregnant women attended at eleven Spanish clinics. A commercial enzyme immunoassay (EIA) was used for screening of serum HTLV-1/2 antibodies. Reactive samples were confirmed by immunoblot. Results A total of 9813 pregnant women with a median age of 34 years-old were examined. Native Spaniards were 6977 (76.5%). Of 2147 foreigners (23.5%), 903566 (9.9%) were Latin Americans, 416 (4.5%) North Africans, 293 (3.2%) from Romania, and 196 (2.1%) from sub-Saharan Africa. A total of 47 samples were EIA reactive but only five were confirmed as HTLV-1 positive using immunoblot. Infected women came from Paraguay, Colombia, the Dominican Republic, Venezuela and Peru. All but one were primigravida, with ages ranging from 20 to 33 years-old. One was HIV-1 positive, and another was infected with Chlamydia trachomatis. Conclusion The overall seroprevalence for HTLV-1 among pregnant women in Spain is 0.05% but rises ten-fold (0.55%) among Latin Americans. This rate is higher than in surveys conducted decades ago. Our results support that anti-HTLV testing should be part of antenatal screening in Spain in pregnant women coming from Latin America, as it is already done with Chagas disease.
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Affiliation(s)
- Begoña Encinas
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Silvia Rojo
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Natalia Montiel
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Antonio Aguilera
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
| | - José María Eiros
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
| | - Juan García-Costa
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
| | - Diego Ortega
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Irene Arco
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
| | - Araceli Hernánez-Batancor
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
| | - Vicente Soriano
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
| | - Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Spanish HTLV Network
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
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de Mendoza C, Carrizo P, Sauleda S, Richart A, Rando A, Miró E, Benito R, Ayerdi O, Encinas B, Aguilera A, Reina G, Rojo S, González R, Fernández-Ruiz M, Liendo P, Montiel N, Roc L, Treviño A, Pozuelo MJ, Soriano V. The slowdown of new infections by human retroviruses has reached a plateau in Spain. J Med Virol 2023; 95:e28779. [PMID: 37212269 DOI: 10.1002/jmv.28779] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/26/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023]
Abstract
The 2022 annual meeting of the HTLV & HIV-2 Spanish Network was held in Madrid on December 14. We summarize here the main information presented and discussed at the workshop and review time trends for human retroviral infections in Spain. As transmissible agents, infections by human retroviruses are of obligatory declaration. Until the end of 2022, the Spanish national registry had recorded 451 cases of HTLV-1, 821 of HTLV-2, and 416 of HIV-2. For HIV-1, estimates are of 150 000 people currently living with HIV-1 and 60 000 cumulative deaths due to AIDS. During year 2022, new diagnoses in Spain were of 22 for HTLV-1, 6 for HTLV-2, and 7 for HIV-2. The last updated figures for HIV-1 are from 2021 and counted 2786 new diagnoses. The slowdown in yearly infections for HIV-1 in Spain points out that new strategies are needed to achieve the United Nations 95-95-95 targets by 2025. For the remaining neglected human retroviral infections, their control might be pushed throughout four interventions: (1) expanding testing; (2) improving education and interventions aimed to reduce risk behaviors; (3) facilitating access to antiretrovirals as treatment and prevention, including further development of long-acting formulations; and (4) increasing vaccine research efforts. Spain is a 47 million population country in South Europe with strong migration flows from HTLV-1 endemic regions in Latin America and Sub-Saharan Africa. At this time universal HTLV screening has been implemented only in the transplantation setting, following the report of 5 cases of HTLV-associated myelopathy shortly after transplantation of organs from HTLV-1 positive donors. There are four target populations for expanding testing and unveiling asymptomatic carriers responsible for silent HTLV-1 transmissions: (1) migrants; (2) individuals with sexually transmitted infections; (3) pregnant women; and (4) blood donors.
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Affiliation(s)
- Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Paula Carrizo
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | | | | | | | - Elisenda Miró
- Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - Rafael Benito
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Begoña Encinas
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Antonio Aguilera
- Department of Microbiology, University of Santiago, Santiago de Compostela, Spain
| | | | - Silvia Rojo
- Hospital Clínico Universitario, Valladolid, Spain
| | | | - Mario Fernández-Ruiz
- Hospital Universitario 12 de Octubre & Instituto de Investigación 12 de Octubre (imas12), CIBERINFEC, Madrid, Spain
| | | | - Natalia Montiel
- Department of Microbiology, University of Cadiz, Cádiz, Spain
| | | | - Ana Treviño
- UNIR Health Sciences School & Medical Center, Madrid, Spain
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Soriano-Ramos M, Esquivel-De la Fuente E, Albert Vicent E, de la Calle M, Baquero-Artigao F, Domínguez-Rodríguez S, Cabanes M, Gómez-Montes E, Goncé A, Valdés-Bango M, Viñuela-Benéitez MC, Muñoz-Chápuli Gutiérrez M, Saavedra-Lozano J, Cuadrado Pérez I, Encinas B, Castells Vilella L, de la Serna Martínez M, Tagarro A, Rodríguez-Molino P, Giménez Quiles E, García Alcázar D, García Burguillo A, Folgueira MD, Navarro D, Blázquez-Gamero D. The role of the T-cell mediated immune response to Cytomegalovirus infection in intrauterine transmission. PLoS One 2023; 18:e0281341. [PMID: 36745589 PMCID: PMC9901742 DOI: 10.1371/journal.pone.0281341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 01/23/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Prognostic markers for fetal transmission of Cytomegalovirus (CMV) infection during pregnancy are poorly understood. Maternal CMV-specific T-cell responses may help prevent fetal transmission and thus, we set out to assess whether this may be the case in pregnant women who develop a primary CMV infection. METHODS A multicenter prospective study was carried out at 8 hospitals in Spain, from January 2017 to April 2020. Blood samples were collected from pregnant women at the time the primary CMV infection was diagnosed to assess the T-cell response. Quantitative analysis of interferon producing specific CMV-CD8+/CD4+ cells was performed by intracellular cytokine flow cytometry. RESULTS In this study, 135 pregnant women with a suspected CMV infection were evaluated, 60 of whom had a primary CMV infection and samples available. Of these, 24 mothers transmitted the infection to the fetus and 36 did not. No association was found between the presence of specific CD4 or CD8 responses against CMV at the time maternal infection was diagnosed and the risk of fetal transmission. There was no transmission among women with an undetectable CMV viral load in blood at diagnosis. CONCLUSIONS In this cohort of pregnant women with a primary CMV infection, no association was found between the presence of a CMV T-cell response at the time of maternal infection and the risk of intrauterine transmission. A detectable CMV viral load in the maternal blood at diagnosis of the primary maternal infection may represent a relevant biomarker associated with fetal transmission.
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Affiliation(s)
- María Soriano-Ramos
- Department of Neonatology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
- * E-mail:
| | - Estrella Esquivel-De la Fuente
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
| | - Eliseo Albert Vicent
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Fernando Baquero-Artigao
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Sara Domínguez-Rodríguez
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
| | - María Cabanes
- Obstetrics Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Enery Gómez-Montes
- Obstetrics Department, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Anna Goncé
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetricia i Neonatologia, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Marta Valdés-Bango
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetricia i Neonatologia, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Mª Carmen Viñuela-Benéitez
- Obstetrics Department, Hospital Gregorio Marañón, Complutense University, Health Research Institute Gregorio Marañón, Madrid, Spain
| | - Mar Muñoz-Chápuli Gutiérrez
- Obstetrics Department, Hospital Gregorio Marañón, Complutense University, Health Research Institute Gregorio Marañón, Madrid, Spain
| | - Jesús Saavedra-Lozano
- Hospital General Universitario Gregorio Marañón, Pediatric Infectious Diseases Unit, Universidad Complutense, Madrid, Spain
| | | | - Begoña Encinas
- Obstetrics Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Laura Castells Vilella
- Department of Neonatology, Hospital Universitari General de Catalunya, Grupo Quiron Salud, Sant Cugat del Vallès, Barcelona, Spain
| | | | - Alfredo Tagarro
- Paediatrics Department, Paediatrics Research Group, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, Spain
| | - Paula Rodríguez-Molino
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Estela Giménez Quiles
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Diana García Alcázar
- Obstetrics Department, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - David Navarro
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Daniel Blázquez-Gamero
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, RITIP, Madrid, Spain
| | - the CYTRIC Study Group
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, RITIP, Madrid, Spain
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López Gómez L, Marín Gabriel MA, Encinas B, de la Cruz Troca JJ, Rodríguez Marrodán B. Oxytocin Receptor Antagonist (Atosiban) in the Threat of Preterm Birth: Does It Have Any Effect on Breastfeeding in the Term Newborn? Breastfeed Med 2018; 13:123-128. [PMID: 29356563 DOI: 10.1089/bfm.2017.0206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM Oxytocin is a hormone involved in the mechanism of breastfeeding, uterine contractions, and social relationships. Atosiban (competitive oxytocin antagonist) is one of the most commonly used tocolytics for the threat of preterm labor in Europe. The aim of this study is to determinate if the administration of atosiban has any influence in the type of feeding in the term newborn at discharge. The secondary objective is to verify its effectiveness for the prevention of preterm delivery and in the possibility of applying treatment to complete lung maturation. MATERIALS AND METHODS Retrospective cohort study carried out in a tertiary University Hospital distinguished by WHO-UNICEF as a Baby-Friendly Hospital Initiative. The analysis included 264 women exposed to atosiban during a period of 4 years. One hundred met inclusion criteria. Unexposed infants born right after and before the exposed ones were selected as the not exposed subgroup (n = 200). RESULTS Among women treated with atosiban, 82% maintained exclusively breastfed (EBF), 8% had mixed breastfeeding, and 10% had formula feeding at discharge. In the nonexposed group, 82% maintained EBF, 9.5% had mixed breastfeeding, and 8.5% had formula feeding at discharge (p = 0.84). 97.5% of pregnant women treated with atosiban received corticosteroid for lung maturation, and 49.5% completed gestation with term newborns. CONCLUSION There were no significant differences in the type of feeding at discharge between the atosiban group and the nonexposed group. In most cases, the administration of tocolytic therapy allowed to complete lung maturation.
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Affiliation(s)
| | - Miguel A Marín Gabriel
- 2 Department of Neonatology, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain .,3 Department of Pediatrics, Autónoma University , Madrid, Spain
| | - Begoña Encinas
- 4 Department of Obstetrics, Puerta de Hierro Majadahonda University Hospital , Madrid, Spain
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Abstract
OBJECTIVE To assess the radiological features of Morel-Lavallée effusion in the thigh. DESIGN AND PATIENTS A retrospective study of clinical records and radiological studies was carried out on three patients with Morel-Lavallée effusion. RESULTS AND CONCLUSIONS Ultrasound and computed tomography (CT) were able to locate the effusion in the three patients. CT demonstrated a capsule around the lesion. A fluid-fluid level was visible with both techniques. Ultrasound and CT are good methods for assessing patients with Morel-Lavallée effusion of the thigh. CT can be used to distinguish patients requiring surgical treatment from those who could be treated by conservative measures.
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Affiliation(s)
- J A Parra
- Servicio Radiodiagnóstico, Hospital Sierrallana, Cantabria, Spain
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