{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:30:00Z","timestamp":1782747000569,"version":"3.54.5"},"reference-count":45,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>HTLV-1-associated Myelopathy\/Tropical Spastic Paraparesis (HAM\/TSP) is a progressive non-remitting and incapacitating disease more frequently seen in women and with a patchy worldwide distribution. HAM\/TSP develops in a small percentage of HTLV-1-infected individuals during their lifetime and etiologic factors for disease progression are still unclear. This study aims to describe the first case series of the progression of HAM\/TSP in relation to pregnancy. Between January and March of 2012, we reviewed medical charts of women with HAM\/TSP currently enrolled in the HTLV-1 cohort at the institute of tropical medicine of Cayetano Heredia University. Inclusion criteria included having a diagnosis of HAM\/TSP according to the WHO guidelines and self-reported initial symptoms of HAM\/TSP during pregnancy or within six months of delivery. Fifteen women reported having had symptoms compatible with HAM\/TSP within four months of delivery. Among them, ten women had no symptoms before pregnancy and reported gait impairment after delivery. Five women with mild gait impairment before pregnancy noticed a worsening of their symptoms after delivery. Symptoms worsened after successive pregnancies. Recent studies have shown that HTLV-1 infection induces a strong T cell-mediated response and that the quality of this response plays a role in HAM\/TSP pathogenesis. The relative immunosuppression during pregnancy, including blunting of the T-cell response, might allowed in certain women enhanced replication of HTLV-1 and disease progression in the postpartum. This is the first study looking specifically at HAM\/TSP and pregnancy and the number of cases is remarkable. Further prospective studies of HTLV-1-infected women assessing immune markers during pregnancy are warranted. Breastfeeding was the main route of transmission. Strategies to prevent vertical transmission need to be evaluated in HTLV-1 endemic countries of Latin America.<\/jats:p>","DOI":"10.3390\/pathogens13090731","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T11:54:10Z","timestamp":1724846050000},"page":"731","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Progression of HTLV-1 Associated Myelopathy\/Tropical Spastic Paraparesis after Pregnancy: A Case Series and Review of the Literature"],"prefix":"10.3390","volume":"13","author":[{"given":"Frederique A.","family":"Jacquerioz","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA"},{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"La Rosa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Gonz\u00e1lez-Lagos","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Tipismana","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"},{"name":"Department of Neurology, Hospital Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Luhmann","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1747-4352","authenticated-orcid":false,"given":"Eduardo","family":"Gotuzzo","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S1473-3099(07)70081-6","article-title":"Human T-lymphotropic virus 1: Recent knowledge about an ancient infection","volume":"7","author":"Verdonck","year":"2007","journal-title":"Lancet Infect. 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