Impacto da carga proviral na infecção neonatal por HTLV-1: Uma revisão de escopo

Introduction: Human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus associated with severe conditions such as adult T-cell leukemia/lymphoma and tropical spastic paraparesis. Despite its epidemiological relevance—particularly in endemic regions such as Salvador, Brazil—the infection remains neglected and often asymptomatic for decades. Mother-to-child transmission represents an important route of infection, with breastfeeding identified as the main associated factor. Evidence suggests that higher maternal proviral load increases the risk of neonatal infection; however, this relationship has not yet been fully clarified in the scientific literature. Objective: To map and synthesize the scientific evidence on the relationship between maternal proviral load and mother-to-child transmission of HTLV-1, describing methodological approaches, studied populations, reported transmission rates, and knowledge gaps. Methods: This scoping review will follow the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidelines. Observational studies assessing maternal proviral load and vertical transmission rates of HTLV-1 will be included. Searches will be conducted in LILACS, PubMed, Embase, SciELO, and BVS databases, complemented by Google Scholar and manual reference screening. Study selection will be performed independently by two reviewers, and data will be extracted using a standardized spreadsheet. Findings will be presented through descriptive analysis and narrative synthesis. Expected results: This review is expected to provide a comprehensive overview of existing evidence, identify research gaps, and support the development of more effective screening, counseling, and prevention strategies, particularly in highly endemic settings.