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Med J Aust. 2016 Oct 3;205(7):305-9.

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

Author information

1
Northern Territory Rural Clinical School, Flinders University, Alice Springs, NT lloyd.einsiedel@nt.gov.au.
2
Baker IDI Heart and Diabetes Institute, Alice Springs, NT.
3
Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA.
4
Poche Centre for Indigenous Health, Flinders University, Alice Springs, NT.

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.

PMID:
27681971
DOI:
10.5694/mja16.00285
[Indexed for MEDLINE]

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