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

The prevalence and clinical associations of HTLV-1 infection in a remote Indigenous community Journal Article

Medical Journal of Australia

• Author(s): Einsiedel, L.J., Pham, H., Woodman, R.J., Pepperill, C., Taylor, K.A.
• Published: 2016
• Volume: 205
• ISBN: 1326-5377 (Electronic) 0025-729X (Linking)

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Abstract: 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.

• Urls: https://www.mja.com.au/journal/2016/205/7/prevalence-and-clinical-associations-htlv-1-infection-remote-indigenous, https://www.ncbi.nlm.nih.gov/pubmed/27681971
• Keywords: Adult, Aged, Child, Comorbidity, Female, HTLV-I Infections/ ethnology, Human T-lymphotropic virus 1/ isolation & purification, Humans, Male, Middle Aged, Northern Territory/epidemiology, Oceanic Ancestry Group, Pilot Projects, Prevalence, Viral Load