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Clin Infect Dis. 2012 Jan 1;54(1):43-50. doi: 10.1093/cid/cir766. Epub 2011 Nov 17.

Bronchiectasis is associated with human T-lymphotropic virus 1 infection in an Indigenous Australian population.

Author information

1
Department of Medicine, Alice Springs Hospital, Alice Springs, Australia. lloyd.einsiedel@health.sa.gov.au

Abstract

BACKGROUND:

Recent studies suggest that infection with human T-lymphotropic virus 1 (HTLV-1) might be associated with bronchiectasis among Indigenous Australians. The present study compared the clinical characteristics and outcomes of bronchiectasis in this population, according to HTLV-1 serologic status.

METHODS:

We performed a retrospective cohort study of Indigenous adults with bronchiectasis and known HTLV-1 serologic status admitted to Alice Springs Hospital, central Australia, from January 2000 through December 2006.

RESULTS:

Among 89 Indigenous adults whose HTLV-1 serologic status was confirmed, 52 (58.4%) were HTLV-1 seropositive. Differences between HTLV-1-seropositive and HTLV-1-seronegative groups were apparent in childhood presentations and adult outcomes. Among adults, an increasing number of bronchiectatic lobes (univariable odds ratio [OR], 1.51; 95% confidence interval [CI]; 1.03-2.20; P = .033) and the presence of ground-glass opacities at chest high-resolution computed tomography (univariable OR, 8.54; 95% CI, 1.04-70.03; P = .046) predicted HTLV-1 infection. Cor pumonale (HTLV-1-positive group, 10/52; HTLV-1-negative group, 1/37; P = .023) was more frequent among HTLV-1-seropositive adults, who also experienced a higher disease-specific mortality (univariable OR, 5.78; 95% CI, 1.17-26.75; P = .028). Only HTLV-1-seropositive patients were admitted specifically for the treatment of infected skin lesions, and this finding predicted death (multivariable OR, 6.77; 95% CI, 1.46-31.34; P = .014). Overall mortality was high; 34.2% of the cohort died at a median age of 42.5 years.

CONCLUSIONS:

HTLV-1 infection contributes to the risk of developing bronchiectasis and worsens outcomes among Indigenous Australians.

PMID:
22095566
DOI:
10.1093/cid/cir766
[Indexed for MEDLINE]

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