Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/5131
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dc.contributor.authorEinsiedel LJen
dc.contributor.authorPham Hen
dc.contributor.authorWilson Ken
dc.contributor.authorWalley Ren
dc.contributor.authorTurpin Jen
dc.contributor.authorBangham Cen
dc.contributor.authorGessain Anen
dc.contributor.authorWoodman RJen
dc.date2018en
dc.date.accessioned2018-05-15T23:00:26Zen
dc.date.available2018-05-15T23:00:26Zen
dc.date.issued2018-03en
dc.identifier.citationPLoS neglected tropical diseases 2018-03; 12(3): e0006281en
dc.identifier.urihttps://hdl.handle.net/10137/5131en
dc.description.abstractThe Human T-Lymphotropic Virus type 1c subtype (HTLV-1c) is highly endemic to central Australia where the most frequent complication of HTLV-1 infection in Indigenous Australians is bronchiectasis. We carried out a prospective study to quantify the prognosis of HTLV-1c infection and chronic lung disease and the risk of death according to the HTLV-1c proviral load (pVL). 840 Indigenous adults (discharge diagnosis of bronchiectasis, 154) were recruited to a hospital-based prospective cohort. Baseline HTLV-1c pVL were determined and the results of chest computed tomography and clinical details reviewed. The odds of an association between HTLV-1 infection and bronchiectasis or bronchitis/bronchiolitis were calculated, and the impact of HTLV-1c pVL on the risk of death was measured. Radiologically defined bronchiectasis and bronchitis/bronchiolitis were significantly more common among HTLV-1-infected subjects (adjusted odds ratio = 2.9; 95% CI, 2.0, 4.3). Median HTLV-1c pVL for subjects with airways inflammation was 16-fold higher than that of asymptomatic subjects. There were 151 deaths during 2,140 person-years of follow-up (maximum follow-up 8.13 years). Mortality rates were higher among subjects with HTLV-1c pVL ≥1000 copies per 105 peripheral blood leukocytes (log-rank χ2 (2df) = 6.63, p = 0.036) compared to those with lower HTLV-1c pVL or uninfected subjects. Excess mortality was largely due to bronchiectasis-related deaths (adjusted HR 4.31; 95% CI, 1.78, 10.42 versus uninfected). Higher HTLV-1c pVL was strongly associated with radiologically defined airways inflammation and with death due to complications of bronchiectasis. An increased risk of death due to an HTLV-1 associated inflammatory disease has not been demonstrated previously. Our findings indicate that mortality associated with HTLV-1c infection may be higher than has been previously appreciated. Further prospective studies are needed to determine whether these results can be generalized to other HTLV-1 endemic areas.en
dc.language.isoengen
dc.titleHuman T-Lymphotropic Virus type 1c subtype proviral loads, chronic lung disease and survival in a prospective cohort of Indigenous Australians.en
dc.typeJournal Articleen
dc.identifier.journaltitlePLoS neglected tropical diseasesen
dc.identifier.doi10.1371/journal.pntd.0006281en
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed//29529032en
dc.identifier.orcidhttp://orcid.org/0000-0002-2517-6083en
dc.identifier.affiliationAboriginal Health Domain, Baker Heart and Diabetes Institute central Australia, Alice Springs Hospital, Alice Springs, Australia..en
dc.identifier.affiliationAboriginal Health Domain, Baker Heart and Diabetes Institute central Australia, Alice Springs Hospital, Alice Springs, Australia..en
dc.identifier.affiliationNational Serology Reference Laboratory, Melbourne, Australia..en
dc.identifier.affiliationFlinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Alice Springs, Australia..en
dc.identifier.affiliationSection of Virology, Division of Infectious Diseases, Department of Medicine, Imperial College London, Norfolk Place, London, United Kingdom..en
dc.identifier.affiliationSection of Virology, Division of Infectious Diseases, Department of Medicine, Imperial College London, Norfolk Place, London, United Kingdom..en
dc.identifier.affiliationInstitut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France, CNRS UMR 3569..en
dc.identifier.affiliationFlinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, Australia..en
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