Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

Einsiedel, Lloyd; Chiong, Fabian; Jersmann, Hubertus; Taylor, Graham P.

doi:10.1186/s12977-020-00543-z

Cited by 27 publications

(28 citation statements)

References 114 publications

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“…Although recent publications, including a systematic review, have suggested a causal relation between HTLV-1 and the development of lung injury [ 10 , 20 ], there are no studies which show the evolution of lung disease in HTLV-1 infected patients. This may be due to the lack of cohort studies needed to follow the evolution of these pulmonary symptoms in carrier patients or monitor infection progress in asymptomatic patients, making it impossible to establish a justifiable causal relationship between the virus and the emergence of lung injuries or symptoms.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study

et al. 2021

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Previous observational studies have demonstrated the development of pulmonary impairments in human T-lymphotropic virus type 1 (HTLV-1) infected individuals. The main observed lesions due to chronic inflammation of viral infection in situ are bronchiectasis and lung-scarring injuries. This lung inflammation may be the causal agent of restrictive and obstructive lung diseases, primarily in tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) patients. We conducted a prospective cohort study to compare spirometry and high-resolution computed tomography (HRCT) findings among 28 HTLV-1-carrier patients over the course of 6 years (2014–2019) (male/female: 7/21; mean age: 54.7 ± 9.5, range: 41–68 years). Chest HRCT exams revealed the development and evolution of lung lesions related to TSP-HAM: including centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. Spirometry exams showed maintenance of respiratory function, with few alterations in parameters suggestive of obstructive and restrictive disorders primarily in individuals with lung lesions and TSP-HAM. The findings of the present study indicate that pulmonary disease related to HTLV-1 is a progressive disease, with development of new lung lesions, mainly in individuals with TSP-HAM. To improve clinical management of these individuals, we recommend that individuals diagnosed with PET-MAH undergo pulmonary evaluation.

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Section: Introductionmentioning

confidence: 99%

Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study

et al. 2021

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“…In terms of non‐infectious pulmonary disease in ATLL patients, abnormal chest CT findings are diverse, including ground‐glass opacities, bronchiectasis, centrilobular nodules and interlobular septal thickening. 4 The incidence of abnormal findings was higher in aggressive ATLL than in indolent ATLL. 5 In the present case, aggressive ATLL was suspected because of the extensive ground‐glass opacities on chest CT and abnormal T lymphocytes and flower cells in peripheral blood.…”

Section: Discussionmentioning

confidence: 92%

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

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Saito

Arita

et al. 2021

Respirology Case Reports

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A 79‐year‐old woman presented to the emergency department with a 1‐week history of progressively worsening dyspnoea on exertion. Chest computed tomography (CT) showed bilateral consolidation. On laboratory findings, the line blot assay for human T‐cell leukaemia virus type 1 was positive, the white blood cell count was 33,000/μl (atypical lymphocytes 8500/μl, 26% of the total white blood cell count) and β‐ d ‐glucan was increased to 391.1 pg/ml. In bronchoalveolar lavage fluid, there was a small number of atypical lymphocytes, and the polymerase chain reaction for Pneumocystis jirovecii was positive. Sulfamethoxazole‐trimethoprim and corticosteroid were administered, but the lung shadows remained. Adult T‐cell lymphoma/leukaemia (ATLL) cell infiltration was suspected, and transbronchial lung cryobiopsy was performed, which showed no infiltration of lymphoma cells into the lung. The lung shadow showed an improving trend on chest CT. She was diagnosed with chronic type ATLL and discharged without chemotherapy.

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“…Prospective studies are necessary to more accurately define the risk of developing disease entities that is associated with a given PVL. However, ensuring that participants are correctly classified at baseline will be extremely difficult, particularly for those with bronchiolitis and early HTLV-1 associated pulmonary disease [ 33 ], and neurological disease not fulfilling HAM criteria [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Very high prevalence of infection with the human T cell leukaemia virus type 1c in remote Australian Aboriginal communities: Results of a large cross-sectional community survey

et al. 2021

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Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. To provide insights into the risk factors for transmission, we conducted the first large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents >2 years old were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 PCR. 720 community residents participated in the study (children <15 years, 142; adults, 578). Prevalences for children and adults were 3.5% (5/142) and 36.8% (213/578), respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants with no difference within groups according to age or gender; however, median PVL was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission.

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Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

Cited by 27 publications

References 114 publications

Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study

Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study

Cryobiopsy for Pneumocystis jirovecii pneumonia secondary to adult T‐cell lymphoma/leukaemia

Very high prevalence of infection with the human T cell leukaemia virus type 1c in remote Australian Aboriginal communities: Results of a large cross-sectional community survey

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