PERFIL DE GESTANTES SUBMETIDAS À TRIAGEM DO VÍRUS HTLV NO MARANHÃO

OBJETIVOS: Avaliar o perfil epidemiológico das gestantes submetidas à triagem para o vírus HTLV 1 e 2, atendidas no pré-natal de três serviços públicos. METODOLOGIA: Estudo transversal realizado entre 11/02 e 03/12/2008, com 2044 gestantes em três serviços públicos de pré-natal, São Luis/MA. As pacientes foram orientadas sobre o estudo, incluídas após assinatura do TCLE e preenchimento do questionário. Participaram gestantes entre 18 e 45 anos sem história de doenças psiquiátricas, hipertensão arterial, nefropatia, diabetes e outros que caracterizassem necessidade de pré-natal especializado. A amostra foi calculada em 2041, poder do teste 95%, erro absoluto de 5%, foi usado programa Stata 9.0, realizado teste qui quadrado e aceito

PREVALÊNCIA DE SOROLOGIA POSITIVA PARA O HTLV-1 E HTLV-2 EM GESTANTES ATENDIDAS EM TRÊS SERVIÇOS PÚBLICOS DE PRÉ-NATAL, SÃO LUIS, JUL/08 A JUL/09

O presente trabalho teve como objetivo identificar a prevalência do vírus HTLV-1 e 2 na triagem de gestantes atendidas em três serviços públicos de pré-natal. A metodologia utilizada foi um estudo transversal, realizado entre julho/08 a julho/09, com 2044 gestantes. As pacientes foram orientadas sobre o estudo e incluídas após assinatura do Termo de Consentimento Livre e Esclarecido (TCLE) e preenchimento do questionário. Participaram gestantes entre 18 e 45 anos, sem história de hipertensão arterial, nefropatia, diabetes, doenças psiquiátricas e outras que caracterizam necessidade de pré-natal especializado. O projeto foi aprovado pelo CEP/HUUFMA. Na triagem usou-se coleta de sangue digital em papel filtro e processada no laboratório do NUPAD - MG, onde fora utilizado a técnica de ensaio imunoenzimático. As gestantes que apresentaram resultado alterado foram contatadas para nova coleta de sangue venoso periférico para testes confirmatórios western blot e PCR. Neste estudo, foram avaliadas 2.044 gestantes. A triagem pelo método ELISA mostrou 07 resultados alterados, sendo 06 reagentes e 01 indeterminado. O exame de Western Blot confirmou todos os resultados reagentes e indeterminados, resultando em prevalência de 0,3% (7/2.044) do vírus HTLV-1/2 entre gestantes atendidas nos serviços públicos de pré-natal de São Luís. Portanto, podemos concluir que apesar de na amostra estudada não ter sido identificada alta prevalência, existe a presença e circulação do vírus na população maranhense.Palavras-chave: HTLV. Gestantes. Pré-natal.AbstractThis research had the objective to identify the prevalence of HTLV-1 and 2 virus in the selection of pregnant women taken care of in the prenatal of three public services. It was used a traversal study, carried out through between jul/08 to jul/09, with 2044 pregnant women. The patients had been guided on the study and enclosed after signature of the TCLE and filling of the questionnaire. They had participated pregnant between 18 and 45 years, without history of high blood pressure, kidney patology, diabetes, psychiatric illnesses and others that would characterize specialized necessity of prenatal. The research was approved by the CEP/HU-UFMA. In the selection collection of digital blood in processed paper was used filter and in the laboratory of NUPAD - MG, to be submitted to the technique of imunoenzimatico assay. The pregnant that had presented resulted modified had been contacted for new collection of peripheral vein blood for confirmatory tests western blot and PCR. This study evaluated 2044 pregnants. The selection by ELISA showed 07 resulted modified, with 06 reagents and 01 indeterminate. The Western Blot test confirmed the results of all reagents and indeterminate, resulting in a prevalence of 0.3% (7/2.044) of HTLV-1/2 among pregnant women in public prenatal care in São Luís. Therefore, we conclude that although the study sample was not identified high prevalence, demonstrating the presence and movement of the virus in the population of Maranhão.Keywords: HTLV. Pregnant Women. Prenatal

High prevalence of HTLV-1 and 2 viruses in pregnant women in São Luis, state of Maranhão, Brazil

INTRODUCTION: Human T cell lymphotropic virus type 1 (HTLV-1) is endemic in the Caribbean, Japan, South America and regions of Africa. HTLV-2 is present in Native American populations and associated with IV drug use in Europe and North America. In Brazil, it is estimated that 1.5 million people are infected with HTLV-1/2. The study objective was to determine HTLV-1/2 prevalence in pregnant women in the prenatal care from three public services in São Luis, State of Maranhão, Brazil, and to counsel seropositive women to reduce viral transmission. METHODS: A cross-sectional study was conducted from February to December 2008; women with age of 18 to 45 years, with low risk for sexually transmitted disease (STD) were invited to participate. Blood samples were collected in filter paper, and HTLV-1/2 immunoenzymatic test (ELISA) was performed as a screening test. Women with reactive results were submitted to peripheral venous blood collection for ELISA repetition, followed by Western blot (WB) and real-time PCR to confirm and discriminate the infection between virus types 1 and 2. RESULTS: Of the 2,044 women tested, seven (0.3%) were ELISA reactive and confirmed positive (four were HTLV-1, and three were HTLV-2). All positive women were oriented not to breastfeed their newborns. CONCLUSIONS: This study showed that the virus is present in high prevalence in that population. Further studies covering other segments of the population are necessary to better characterize the presence of HTLV-1/2 in Maranhão and to elicit measures to prevent its spread