Women living with HTLV-1 should have the opportunity to make informed decisions on prevention of mother-to-child transmission

No one could disagree with the title of the Comment by Jane Fisher1 in response to our health economic research2 —ie, “Recommendations against breastfeeding require consultation with women for effective implementation”. Such consultations with women living with human T-cell lymphotropic virus type 1 (HTLV-1) shaped our research,2 while the absence of antenatal screening excludes women from any shared decision making. We endorse the need for antenatal screening but ensuring optimal resource allocation is key and drove our economic analysis of HTLV-1 antenatal screening. Because we used the perspective of the Ministry of Health, the costs to parents, as suggested in the Comment,1 cannot be considered.

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