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Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021
- Carolina Rosadas1 , Milene Costa2,3 , Kátia Senna2 , Marisa Santos2 , Graham P Taylor1,4
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View Affiliations Hide AffiliationsAffiliations: 1 Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom 2 Núcleo de Avaliação de Tecnologias em Saúde, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil 3 Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil 4 National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United KingdomCarolina Rosadasc.rosadas-de-oliveira imperial.ac.uk
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Citation style for this article: Rosadas Carolina, Costa Milene, Senna Kátia, Santos Marisa, Taylor Graham P. Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021. Euro Surveill. 2024;29(22):pii=2300537. https://doi.org/10.2807/1560-7917.ES.2024.29.22.2300537 Received: 06 Oct 2023; Accepted: 17 Feb 2024
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Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) is a neglected virus that can cause severe disease and be transmitted from mother to child through breastfeeding. Avoidance of breastfeeding prevents 80% of vertical transmission. The United Kingdom (UK) is currently assessing whether HTLV-1-targeted antenatal screening should be implemented.
We aimed to assess the impact and cost-effectiveness of a targeted programme to prevent HTLV-1 vertical transmission in England and Wales.
We estimated the number of pregnant women who have high risk of HTLV-1 infection based on their or their partner’s country of birth. With data from 2021, we used a mathematical model to assess cost-effectiveness of HTLV-1 antenatal screening. We also estimated the annual number of infant infections and the number that could be prevented with screening and intervention.
We estimate that ca 99,000 pregnant women in England and Wales have high risk of HTLV-1 infection. In the absence of screening, 74 (range: 25–211) HTLV-1 infections in infants would be expected to occur every year in England and Wales. Implementation of targeted screening would prevent 58 (range: 19–164) infant infections annually. The intervention is effective (incremental 0.00333 quality-adjusted life years (QALY)) and cost-saving (GBP −57.56 (EUR −66.85)).
Our findings support implementation of HTLV-1 targeted antenatal screening to reduce vertical transmission from mothers to infants in the UK.
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