Human T-cell leukemia virus (HTLV)

Can I breastfeed if I have HTLV?

HTLV, or human T-cell leukemia virus, causes serious disease in some people, including blood cancer and chronic lung disease. It can be transmitted from mother to child during pregnancy or breastfeeding. The transmission rate from mother to child ranges from 4% to 30%, with most of these infections caused by breastfeeding. There is no treatment or vaccine for HTLV. Mothers who are HTLV-positive balance the risk of infection and disease with HTLV and the risks of not breastfeeding.

A) Describing human T-cell leukemia virus

Human T-cell lymphotropic virus (HTLV) has two dangerous types (HTLV-1 and HTLV-2) and is in the same family of viruses (retroviruses) as HIV, the virus that causes AIDS.

In some people, HTLV causes severe disease:

  • Blood cancer (leukemia and lymphoma)
  • Nervous system damage  
  • Disease of the joints (rheumatic syndromes)
  • Chronic lung disease

HTLV-1 and HTLV-2 are diagnosed using blood tests. Some countries will test mothers before they give birth. There is no treatment or vaccine.

Please see your health-care providers for more information.

B) Breastfeeding with HTLV

HTLV is found in different parts of the world and is transmitted in a number of ways (Gonçalves 2010):

  • Mother-to-child contact
    • During pregnancy
    • By breastfeeding
  • Sexual contact
  • Blood transfusion
  • Sharing contaminated needles

The transmission rate from mother to child ranges from 4% to 30%, with most of these infections caused by breastfeeding (Biggar 2006; Carneiro-Proietti 2014).

Recommendations on breastfeeding by HTLV-positive mothers vary by region and country. The decision whether to breastfeed must weigh the risk of infection and disease with HTLV and the risks of not breastfeeding.Mothers who decide not to breastfeed need to make sure that using infant formula is possible, affordable, and safe.

References

Biggar RJ, Ng J, Kim N, et al. Human leukocyte antigen concordance and the transmission risk via breast-feeding of human T cell lymphotropic virus type I. J Infect Dis. 2006 Jan 15;193(2):277-82
 
Carneiro-Proietti AB, Amaranto-Damasio MS, Leal-Horiguchi CF, et al. Mother-to-Child Transmission of Human T-Cell Lymphotropic Viruses-1/2: What We Know, and What Are the Gaps in Understanding and Preventing This Route of Infection.  J Pediatric Infect Dis Soc. 2014;3 Suppl 1(Suppl 1):S24-9
 
Gonçalves DU, Proietti FA, Ribas JG, et al. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev. 2010 Jul;23(3):577-89