Events

At this special Doherty Seminar Series event for World HTLB Day, Associate Professor Lloyd Einsiedel, Infectious Diseases Physician, Alice Springs Hospital, presents The Human T-cell Leukaemia Virus: a neglected infection in remote central Australia.

This is a hybrid event. Join in-person in the Auditorium or online via Zoom.

Ground Level Auditorium
Doherty Institute
792 Elizabeth Street, Melbourne

Zoom URL: https://unimelb.zoom.us/j/82261161671?pwd=WHNqeSs5WjJ1b0ZRd1pUbUtuTDFwdz09
Webinar ID: 822 6116 1671
Passcode: 369794

Bio

Lloyd is a clinical researcher and specialist physician with extensive clinical and research experience in remote Australia where he runs multi-disciplinary projects designed to provide actionable information to vulnerable communities. His clinical experience in a region with the highest worldwide prevalence of HTLV-1 led to a particular interest in the epidemiology and pathophysiology of HTLV-1 associated diseases.

Abstract

The Human T-cell Leukaemia Virus type 1 (HTLV-1) is a human retrovirus with a global distribution. The virus is highly prevalent among Aboriginal people in central Australia where adult prevalence rates exceed 40% in some remote communities. HTLV-1 causes a rapidly progressive haematological malignancy (adult T-cell leukaemia, ATL) and is associated with inflammatory diseases that involve organ systems including the eyes, spinal cord and lungs. These conditions are associated with high numbers of HTLV-1 infected cells in peripheral blood, the HTLV-1 proviral load.

Working with Aboriginal communities in central Australia, the clinical manifestations and risk factors for these diseases have been studied over the past decade. Although HTLV-1 associated pulmonary disease is most common, each of the major recognized HTLV-1 associated diseases, including ATL, has been reported. Epidemiological studies confirm extraordinarily high rates of chronic lung disease in remote Aboriginal communities; a clinical diagnosis of chronic suppurative lung disease was made for 16.7%, with radiological evidence of bronchiolitis/bronchiectasis in 12.5%, of adults with HTLV-1. A high HTLV-1 proviral load in peripheral blood was strongly associated with chronic airways inflammation in both community and hospital-based studies, and predicted a bronchiectasis-associated death at a mean age of only 50 years in a hospital-based cohort. Consistent with known interactions between chronic inflammation and non-communicable diseases, higher numbers of pro-inflammatory HTLV-1 infected cells in peripheral blood also increased risk of diabetes and chronic kidney disease in a community setting. Prospective follow-up of this community-based cohort has more recently demonstrated that adults with high HTLV-1 proviral loads experience significantly higher admission rates, and a higher cumulative incidence rate, for conditions including respiratory diseases, infectious diseases and diabetes.

Emerging data suggest a complex interplay between HTLV-1 infection and organ damage that increases health service utilization and may account for the increased risk of death that has been reported in all endemic areas where this has been studied. No direct acting anti-viral agents have been developed to treat HTLV-1 infection, making public health interventions essential to reduce infection rates. Nevertheless, more than three decades after the virus was first identified in central Australia, no coordinated public health response has been implemented to reduce transmission in remote communities.