Human T cell leukaemia/lymphoma virus infection in pregnant women in the United Kingdom: population study

Objective To assess the prevalence of human T cell leukaemia /lymphoma viru s (HTLV) infection in pregnant women in the United Kingdom. Design Population study. Subjects Guthrie card samples from babies born in 1997-8. Samples were link ed to data on mother's age and ethnic status and parents' country of birth and then anonymised. Setting North Thames Regional Health Authority Main outcome measures Presence of antibodies against HTLV in eluates tested by gelatin particle agglutination assay and results confirmed by immunoblo t Results Of 126 010 samples tested, 67 had confirmed antibodies to HTLV (59 HTLV-I, 2 HTLV-II, 6 untyped) and six had indeterminate results. Seropreval ence was 17.0 per 1000 (95% confidence interval 9.2 to 28.3) in infants who se mothers were born in the Caribbean, 3.2/1000 (1.5 to 5.9) with mothers b orn in west and central Africa, and 6.8/1000 (3.1 to 12.9) in infants of bl ack Caribbean mothers born in non-endemic regions. In infants with no known risk (both parents born in non-endemic regions and mother not black Caribb ean) seroprevalence was 0.06-0.12 per 1000. Mother's country of birth, fath er's country of birth, and mother's ethnic status were all independently as sociated with neonatal seroprevalence. An estimated 223 (95% confidence int erval 110 to 350) of the 720 000 pregnant women each year in the United Kin gdom are infected with HTLV. Conclusions The prevalence of HTLV and HIV infections in pregnant women in the United Kingdom are comparable. The cost effectiveness of antenatal HTLV screening should be evaluated, and screening of blood donations should be considered.