Pulmonary disease is associated with human T-cell leukaemia virus type 1c infection: a cross-sectional survey in remote Aboriginal Australian communities

Pulmonary disease is associated with human T-cell leukaemia virus type 1c infection: a cross-sectional survey in remote Aboriginal Australian communities Journal Article

Clinical Infectious Diseases

• Author(s): Einsiedel, Lloyd, Pham, Hai, Talukder, Mohammad Radwanur R., Liddle, Joel, Taylor, Kerry, Wilson, Kim, Jersmann, Hubertus, Gessain, Antoine, Woodman, Richard, Kaldor, John
• Published: 2020
• ISBN: 1058-4838

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Abstract: The human T-cell leukaemia virus type 1 (HTLV-1) subtype c is endemic to central Australia. We report the first large-scale, community-based, health survey of HTLV-1 and its disease associations in this setting.Aboriginal community residents aged >2 years in seven remote communities were invited to do a health survey that included a questionnaire, spirometry and clinical examination by a physician blinded to HTLV-1 status, clinical records and spirometry results. Blood was drawn for HTLV-1 serology and proviral load (PVL). Pulmonary disease was assessed clinically and spirometrically and, where records were available, radiologically after the clinical assessment. Associations between specific diseases and HTLV-1 status were determined using logistic regression, adjusting for available confounders.Overall, 579 residents (children aged 3-17, 164; adults, 415) were examined (37.7% of the estimated resident population). HTLV-1 prevalences for children and adults were 6.1% and 39.3%, respectively. No associations were found between HTLV-1 and any assessed clinical condition among children. Chronic pulmonary disease and gait abnormalities were more common among adults with HTLV-1 infection. Adjusted odds ratios (aOR)(95% CI) among participants with PVL ≥ 1000 per 10 5 PBL were 7.08 (2.67, 18.74; p<0.001), 9.81 (3.52, 27.35; p<0.001) and 14.4 (4.99, 41.69; p<0.001) for clinically defined chronic pulmonary disease, moderate-severe expiratory airflow limitation and radiologically determined bronchiectasis/bronchiolitis, respectively, and 5.21 (1.50, 18.07; p=0.009) for gait abnormalities.In the first study of HTLV-1 disease associations based on community recruitment and blinded assessment, HTLV-1 infection was strongly associated with pulmonary disease and gait abnormalities.

• Urls: https://doi.org/10.1093/cid/ciaa1401
• Keywords: HTLV-1, central Australia, Aboriginal, pulmonary disease, gait abnormalities