Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10156
Title: Higher HTLV-1c proviral loads are associated with blood stream infections in an Indigenous Australian population.
Authors: Einsiedel, Lloyd
Cassar, Olivier
Spelman, Tim
Joseph, Sheela
Gessain, Antoine
Affiliation: Northern Territory Rural Clinical School/Flinders University, Northern Territory of Australia, Australia; Department of Medicine, Alice Springs Hospital, Alice Springs, Australia. Electronic address: lloyd.einsiedel@nt.gov.au..
Institut Pasteur, Unité EPVO, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France..
Northern Territory Rural Clinical School/Flinders University, Northern Territory of Australia, Australia..
Northern Territory Rural Clinical School/Flinders University, Northern Territory of Australia, Australia..
Institut Pasteur, Unité EPVO, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France..
Issue Date: May-2016
Citation: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 2016-05; 78: 93-8
Abstract: An association between blood stream infections (BSI) and HTLV-1 seropositivity in Indigenous Australians might result from HTLV-1 mediated inflammation and parasite coinfections that provide portals of entry for bacteria. To determine whether BSI risk increases with HTLV-1c proviral load (PVL) and to identify the pathogens responsible in the context of HTLV-1 related conditions. Indigenous adults admitted to Alice Springs Hospital, central Australia, were recruited as cases or controls according to whether they had a BSI. Clinical data were extracted from case notes and the hospital pathology database. HTLV-1 serology and PVL assays were then performed and risk factors for BSI were determined for HTLV-1 infected subjects. Risk factors were compared between 44 cases and 30 controls who were HTLV-1 Western blot positive. In a multivariable model, high HTLV-1c PVL was predictive of BSI during the study period (OR, 9.10; 95% CI, 2.40-34.4). Median (IQR) HTLV-1c PVL (copies per 100 PBL) was 39-fold higher for patients recording any BSI (0.116 (0.009, 0.277)) relative to those who had no BSI (0.003 (0.000, 0.067))(p=0.0007). Mean (SD) PVL for subjects with no BSI (n=27), 1 BSI (n=37) and ≥2 BSI (n=10) during the study period were 0.120 (0.301), 0.271 (0.622) and 0.500 (0.654) copies per 100 PBL, respectively (p=0.0007). Five BSI were associated with possible complications of HTLV-1; strongyloidiasis (3), infective dermatitis (1), HTLV-1 associated bronchiectasis (1). Higher HTLV-1c PVL predicts BSI risk; however; most BSI were not associated with recognised complications of HTLV-1 infection.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10156
DOI: 10.1016/j.jcv.2016.03.006
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: Adolescent
Adult
Aged
Aged, 80 and over
Australia
Bacteremia
Female
HTLV-I Infections
Human T-lymphotropic virus 1
Humans
Male
Middle Aged
Population Groups
Proviruses
Risk Assessment
Young Adult
Viral Load
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