Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population
Identifieur interne : 003B32 ( Main/Exploration ); précédent : 003B31; suivant : 003B33Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population
Auteurs : Lloyd Einsiedel [Australie] ; Tim Spelman [Australie] ; Emma Goeman [Australie] ; Olivier Cassar [France] ; Mick Arundell [Australie] ; Antoine Gessain [France]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Analyse de survie, Australie (épidémiologie), Comorbidité, Femelle, Groupes de population, Hospitalisation (), Humains, Infections à HTLV-I (anatomopathologie), Infections à HTLV-I (mortalité), Infections à HTLV-I (épidémiologie), Mâle, Virus T-lymphotrope humain de type 1 (isolement et purification), Études séroépidémiologiques.
- MESH :
- anatomopathologie : Infections à HTLV-I.
- isolement et purification : Virus T-lymphotrope humain de type 1.
- mortalité : Infections à HTLV-I.
- épidémiologie : Australie, Infections à HTLV-I.
- Adulte, Adulte d'âge moyen, Analyse de survie, Comorbidité, Femelle, Groupes de population, Hospitalisation, Humains, Mâle, Études séroépidémiologiques.
- Wicri :
- geographic : Australie.
English descriptors
- KwdEn :
- Adult, Australia (epidemiology), Comorbidity, Female, HTLV-I Infections (epidemiology), HTLV-I Infections (mortality), HTLV-I Infections (pathology), Hospitalization (statistics & numerical data), Human T-lymphotropic virus 1 (isolation & purification), Humans, Male, Middle Aged, Population Groups, Seroepidemiologic Studies, Survival Analysis.
- MESH :
- geographic , epidemiology : Australia.
- epidemiology : HTLV-I Infections.
- isolation & purification : Human T-lymphotropic virus 1.
- mortality : HTLV-I Infections.
- pathology : HTLV-I Infections.
- statistics & numerical data : Hospitalization.
- Adult, Comorbidity, Female, Humans, Male, Middle Aged, Population Groups, Seroepidemiologic Studies, Survival Analysis.
Abstract
In resource-poor areas, infectious diseases may be important causes of morbidity among individuals infected with the Human T-Lymphotropic Virus type 1 (HTLV-1). We report the clinical associations of HTLV-1 infection among socially disadvantaged Indigenous adults in central Australia.
HTLV-1 serological results for Indigenous adults admitted 1st January 2000 to 31st December 2010 were obtained from the Alice Springs Hospital pathology database. Infections, comorbid conditions and HTLV-1 related diseases were identified using ICD-10 AM discharge morbidity codes. Relevant pathology and imaging results were reviewed. Disease associations, admission rates and risk factors for death were compared according to HTLV-1 serostatus. HTLV-1 western blots were positive for 531 (33.3%) of 1595 Indigenous adults tested. Clinical associations of HTLV-1 infection included bronchiectasis (adjusted Risk Ratio, 1.35; 95% CI, 1.14–1.60), blood stream infections (BSI) with enteric organisms (aRR, 1.36; 95% CI, 1.05–1.77) and admission with strongyloidiasis (aRR 1.38; 95% CI, 1.16–1.64). After adjusting for covariates, HTLV-1 infection remained associated with increased numbers of BSI episodes (adjusted negative binomial regression, coefficient, 0.21; 95% CI, 0.02–0.41) and increased admission numbers with strongyloidiasis (coefficient, 0.563; 95% CI, 0.17–0.95) and respiratory conditions including asthma (coefficient, 0.99; 95% CI, 0.27–1.7), lower respiratory tract infections (coefficient, 0.19; 95% CI, 0.04–0.34) and bronchiectasis (coefficient, 0.60; 95% CI, 0.02–1.18). Two patients were admitted with adult T-cell Leukemia/Lymphoma, four with probable HTLV-1 associated myelopathy and another with infective dermatitis. Independent predictors of mortality included BSI with enteric organisms (aRR 1.78; 95% CI, 1.15–2.74) and bronchiectasis (aRR 2.07; 95% CI, 1.45–2.98).
HTLV-1 infection contributes to morbidity among socially disadvantaged Indigenous adults in central Australia. This is largely due to an increased risk of other infections and respiratory disease. The spectrum of HTLV-1 related diseases may vary according to the social circumstances of the affected population.
Url:
DOI: 10.1371/journal.pntd.0002643
PubMed: 24454973
PubMed Central: 3894183
Affiliations:
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Indigenous Australian Population</title><author><name sortKey="Einsiedel, Lloyd" sort="Einsiedel, Lloyd" uniqKey="Einsiedel L" first="Lloyd" last="Einsiedel">Lloyd Einsiedel</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Flinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Alice Springs, Northern Territory, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Flinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Alice Springs, Northern Territory</wicri:regionArea><wicri:noRegion>Northern Territory</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>SAPathology, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>SAPathology, Flinders Medical Centre, Bedford Park, Adelaide, South Australia</wicri:regionArea><wicri:noRegion>South 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Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arundell, Mick" sort="Arundell, Mick" uniqKey="Arundell M" first="Mick" last="Arundell">Mick Arundell</name><affiliation wicri:level="1"><nlm:aff id="aff6"><addr-line>Clinical Information Analyst, Central Australian Health Network, Alice Springs Hospital, Alice Springs, Northern Territory, Australia</addr-line></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Clinical Information Analyst, Central Australian Health Network, Alice Springs Hospital, Alice Springs, Northern Territory</wicri:regionArea><wicri:noRegion>Northern Territory</wicri:noRegion></affiliation></author><author><name sortKey="Gessain, Antoine" sort="Gessain, Antoine" uniqKey="Gessain A" first="Antoine" last="Gessain">Antoine Gessain</name><affiliation wicri:level="3"><nlm:aff id="aff4"><addr-line>Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="aff5"><addr-line>CNRS, UMR 3569, Paris, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CNRS, UMR 3569, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Australia (epidemiology)</term><term>Comorbidity</term><term>Female</term><term>HTLV-I Infections (epidemiology)</term><term>HTLV-I Infections (mortality)</term><term>HTLV-I Infections (pathology)</term><term>Hospitalization (statistics & numerical data)</term><term>Human T-lymphotropic virus 1 (isolation & purification)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Population Groups</term><term>Seroepidemiologic Studies</term><term>Survival Analysis</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Australie (épidémiologie)</term><term>Comorbidité</term><term>Femelle</term><term>Groupes de population</term><term>Hospitalisation ()</term><term>Humains</term><term>Infections à HTLV-I (anatomopathologie)</term><term>Infections à HTLV-I (mortalité)</term><term>Infections à HTLV-I (épidémiologie)</term><term>Mâle</term><term>Virus T-lymphotrope humain de type 1 (isolement et purification)</term><term>Études séroépidémiologiques</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Australia</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infections à HTLV-I</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HTLV-I Infections</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Human T-lymphotropic virus 1</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Virus T-lymphotrope humain de type 1</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>HTLV-I Infections</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à HTLV-I</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>HTLV-I Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Australie</term><term>Infections à HTLV-I</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Comorbidity</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Population Groups</term><term>Seroepidemiologic Studies</term><term>Survival Analysis</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse de survie</term><term>Comorbidité</term><term>Femelle</term><term>Groupes de population</term><term>Hospitalisation</term><term>Humains</term><term>Mâle</term><term>Études séroépidémiologiques</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Australie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>In resource-poor areas, infectious diseases may be important causes of morbidity among individuals infected with the Human T-Lymphotropic Virus type 1 (HTLV-1). We report the clinical associations of HTLV-1 infection among socially disadvantaged Indigenous adults in central Australia.</p></sec><sec><title>Methodology and Principal Findings</title><p>HTLV-1 serological results for Indigenous adults admitted 1<sup>st</sup> January 2000 to 31<sup>st</sup> December 2010 were obtained from the Alice Springs Hospital pathology database. Infections, comorbid conditions and HTLV-1 related diseases were identified using ICD-10 AM discharge morbidity codes. Relevant pathology and imaging results were reviewed. Disease associations, admission rates and risk factors for death were compared according to HTLV-1 serostatus. HTLV-1 western blots were positive for 531 (33.3%) of 1595 Indigenous adults tested. Clinical associations of HTLV-1 infection included bronchiectasis (adjusted Risk Ratio, 1.35; 95% CI, 1.14–1.60), blood stream infections (BSI) with enteric organisms (aRR, 1.36; 95% CI, 1.05–1.77) and admission with strongyloidiasis (aRR 1.38; 95% CI, 1.16–1.64). After adjusting for covariates, HTLV-1 infection remained associated with increased numbers of BSI episodes (adjusted negative binomial regression, coefficient, 0.21; 95% CI, 0.02–0.41) and increased admission numbers with strongyloidiasis (coefficient, 0.563; 95% CI, 0.17–0.95) and respiratory conditions including asthma (coefficient, 0.99; 95% CI, 0.27–1.7), lower respiratory tract infections (coefficient, 0.19; 95% CI, 0.04–0.34) and bronchiectasis (coefficient, 0.60; 95% CI, 0.02–1.18). Two patients were admitted with adult T-cell Leukemia/Lymphoma, four with probable HTLV-1 associated myelopathy and another with infective dermatitis. Independent predictors of mortality included BSI with enteric organisms (aRR 1.78; 95% CI, 1.15–2.74) and bronchiectasis (aRR 2.07; 95% CI, 1.45–2.98).</p></sec><sec><title>Conclusion</title><p>HTLV-1 infection contributes to morbidity among socially disadvantaged Indigenous adults in central Australia. This is largely due to an increased risk of other infections and respiratory disease. The spectrum of HTLV-1 related diseases may vary according to the social circumstances of the affected population.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Verdonck, K" uniqKey="Verdonck K">K Verdonck</name></author><author><name sortKey="Gonzalez, E" uniqKey="Gonzalez E">E Gonzalez</name></author><author><name sortKey="Van Dooren, S" uniqKey="Van Dooren S">S Van Dooren</name></author><author><name sortKey="Vandamme, A" uniqKey="Vandamme A">A Vandamme</name></author><author><name sortKey="Vanham, G" uniqKey="Vanham G">G Vanham</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gessain, A" uniqKey="Gessain A">A Gessain</name></author><author><name sortKey="Cassar, O" uniqKey="Cassar O">O Cassar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cassar, O" uniqKey="Cassar O">O Cassar</name></author><author><name sortKey="Einsiedel, L" uniqKey="Einsiedel 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sortKey="Morris, P" uniqKey="Morris P">P Morris</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="Australie"><noRegion><name sortKey="Einsiedel, Lloyd" sort="Einsiedel, Lloyd" uniqKey="Einsiedel L" first="Lloyd" last="Einsiedel">Lloyd Einsiedel</name></noRegion><name sortKey="Arundell, Mick" sort="Arundell, Mick" uniqKey="Arundell M" first="Mick" last="Arundell">Mick Arundell</name><name sortKey="Einsiedel, Lloyd" sort="Einsiedel, Lloyd" uniqKey="Einsiedel L" first="Lloyd" last="Einsiedel">Lloyd Einsiedel</name><name sortKey="Goeman, Emma" sort="Goeman, Emma" uniqKey="Goeman E" first="Emma" last="Goeman">Emma Goeman</name><name sortKey="Spelman, Tim" sort="Spelman, Tim" uniqKey="Spelman T" first="Tim" last="Spelman">Tim Spelman</name></country><country name="France"><region name="Île-de-France"><name sortKey="Cassar, Olivier" sort="Cassar, Olivier" uniqKey="Cassar O" first="Olivier" last="Cassar">Olivier Cassar</name></region><name sortKey="Cassar, Olivier" sort="Cassar, Olivier" uniqKey="Cassar O" first="Olivier" last="Cassar">Olivier Cassar</name><name sortKey="Gessain, Antoine" sort="Gessain, Antoine" uniqKey="Gessain A" first="Antoine" last="Gessain">Antoine Gessain</name><name sortKey="Gessain, Antoine" sort="Gessain, Antoine" uniqKey="Gessain A" first="Antoine" last="Gessain">Antoine Gessain</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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