Human T-Lymphotropic Virus type 1 infective dermatitis in central Australia

Einsiedel, Lloyd; Cassar, Olivier; Gordon, Lynne Thomas; Gessain, Antoine

doi:10.1016/j.jcv.2013.04.022

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…Interactions between HTLV-1 related inflammatory diseases and infection have also been demonstrated. Infective dermatitis, for example, typically affects HTLV-1 carriers from lower socio-economic backgrounds and predisposes to skin infections with bacterial pathogens [7], which may progress to life-threatening invasive disease [16]. Recently, we reported high rates of HTLV-1 infection among socially disadvantaged Indigenous adults with bronchiectasis in central Australia [17].…”

Section: Introductionmentioning

confidence: 99%

Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population

et al. 2014

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IntroductionIn resource-poor areas, infectious diseases may be important causes of morbidity among individuals infected with the Human T-Lymphotropic Virus type 1 (HTLV-1). We report the clinical associations of HTLV-1 infection among socially disadvantaged Indigenous adults in central Australia.Methodology and Principal FindingsHTLV-1 serological results for Indigenous adults admitted 1st January 2000 to 31st December 2010 were obtained from the Alice Springs Hospital pathology database. Infections, comorbid conditions and HTLV-1 related diseases were identified using ICD-10 AM discharge morbidity codes. Relevant pathology and imaging results were reviewed. Disease associations, admission rates and risk factors for death were compared according to HTLV-1 serostatus. HTLV-1 western blots were positive for 531 (33.3%) of 1595 Indigenous adults tested. Clinical associations of HTLV-1 infection included bronchiectasis (adjusted Risk Ratio, 1.35; 95% CI, 1.14–1.60), blood stream infections (BSI) with enteric organisms (aRR, 1.36; 95% CI, 1.05–1.77) and admission with strongyloidiasis (aRR 1.38; 95% CI, 1.16–1.64). After adjusting for covariates, HTLV-1 infection remained associated with increased numbers of BSI episodes (adjusted negative binomial regression, coefficient, 0.21; 95% CI, 0.02–0.41) and increased admission numbers with strongyloidiasis (coefficient, 0.563; 95% CI, 0.17–0.95) and respiratory conditions including asthma (coefficient, 0.99; 95% CI, 0.27–1.7), lower respiratory tract infections (coefficient, 0.19; 95% CI, 0.04–0.34) and bronchiectasis (coefficient, 0.60; 95% CI, 0.02–1.18). Two patients were admitted with adult T-cell Leukemia/Lymphoma, four with probable HTLV-1 associated myelopathy and another with infective dermatitis. Independent predictors of mortality included BSI with enteric organisms (aRR 1.78; 95% CI, 1.15–2.74) and bronchiectasis (aRR 2.07; 95% CI, 1.45–2.98).ConclusionHTLV-1 infection contributes to morbidity among socially disadvantaged Indigenous adults in central Australia. This is largely due to an increased risk of other infections and respiratory disease. The spectrum of HTLV-1 related diseases may vary according to the social circumstances of the affected population.

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Section: Introductionmentioning

confidence: 99%

Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population

et al. 2014

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“…[2][3][4][5] However, there have been relatively few case reports of HTLV-1 associated myelopathy, or adult T-cell leukaemia/lymphoma, the most well-known sequelae of HTLV-1 infection documented in this population. 6,7 Accordingly, the role of HTLV-1 infection within the Central Australian population has remained largely under-appreciated.…”

Section: Introductionmentioning

confidence: 99%

Human T-lymphotropic virus-1 serology in the Northern Territory: 2008–2011

2014

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“…HTLV‐1 was first identified in central Australia in 1988 9 and each of the major recognised complications of HTLV‐1 have since been described in Indigenous residents of this region 3 , 5 , 10 , 11 . HTLV‐1‐associated pulmonary disease is particularly common 6 , 10 , 12 and contributes to the highest reported adult prevalence of bronchiectasis worldwide 6 .…”

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The prevalence and clinical associations of HTLV‐1 infection in a remote Indigenous community

Einsiedel

Pham

Woodman

et al. 2016

Medical Journal of Australia

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Objective: Hospital and laboratory data indicate that human T‐lymphotropic virus type 1 (HTLV‐1) is endemic to central Australia, but no community‐based studies of its prevalence or disease burden have been reported. We determined the prevalence rates of HTLV‐1 infection and of HTLV‐1‐associated diseases in a remote Indigenous community. Setting: A remote Northern Territory community. Design: All residents were asked to complete a health survey and offered a limited clinical examination, together with serological tests for HTLV‐1 and Strongyloides, and HTLV‐1 proviral load (PVL) assessment. Main outcome measures: HTLV‐1 seropositivity rates; HTLV‐1 PVL (copies/105 peripheral blood leucocytes [PBL]); presentation with HTLV‐1‐related clinical disease. Results: HTLV‐1 serostatus was determined for 97 of 138 residents (70%). The prevalence of HTLV‐1 infection was significantly higher among adults (30 of 74 people tested) than children (1 of 23; P = 0.001). Nine of 30 HTLV‐1‐positive adults had a clinical syndrome that was potentially attributable to HTLV‐1 infection (chronic lung disease, seven; symptomatic strongyloidiasis, two). The median HTLV‐1 PVL was significantly higher for adults with chronic lung disease than for those who were asymptomatic (chronic lung disease, 649 copies/105 PBL [IQR, 162–2220]; asymptomatic adults, 40 copies/105 PBL [IQR, 0.9–229]; P = 0.017). Ten of 72 adults tested were seropositive for Strongyloides (six of 28 HTLV‐1‐positive participants and four of 44 HTLV‐1‐negative participants; P = 0.17), as were three of 15 children tested; the three children were HTLV‐1‐negative. Conclusion: The prevalence of HTLV‐1 infection and the rate of disease potentially attributable to HTLV‐1 were high among adults in this remote community.

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Human T-Lymphotropic Virus type 1 infective dermatitis in central Australia

Cited by 13 publications

References 19 publications

Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population

Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population

Human T-lymphotropic virus-1 serology in the Northern Territory: 2008–2011

The prevalence and clinical associations of HTLV‐1 infection in a remote Indigenous community

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