PT  - JOURNAL ARTICLE
AU  - Fabiola Martin
AU  - Charles F Gilks
AU  - Robert Gibb
AU  - Alana Jenkins
AU  - Melinda Protani
AU  - Fleur Francis
AU  - Andrew M Redmond
AU  - Graham Neilsen
AU  - David Mudge
AU  - Martin Wolley
AU  - Enzo Binotto
AU  - Robert Norton
AU  - Graeme R Nimmo
AU  - Claire Heney
TI  - Human T-cell leukaemia virus type 1 and Adult T-cell leukaemia/lymphoma in Queensland, Australia: a retrospective cross-sectional study
AID  - 10.1136/sextrans-2021-055241
DP  - 2022 May 06
TA  - Sexually Transmitted Infections
PG  - sextrans-2021-055241
4099  - http://sti.bmj.com/content/early/2022/05/06/sextrans-2021-055241.short
4100  - http://sti.bmj.com/content/early/2022/05/06/sextrans-2021-055241.full
AB  - Objectives Human T-cell leukaemia virus type 1 (HTLV-1), an STI, is reported to be highly prevalent in Indigenous communities in Central Australia. HTLV-1 is an incurable, chronic infection which can cause Adult T-cell leukaemia/lymphoma (ATL). ATL is associated with high morbidity and mortality, with limited treatment options. We studied the prevalence of HTLV-1 and ATL in the state of Queensland, Australia.Methods Serum samples stored at healthcare services in Brisbane, Townsville and Cairns and at haemodialysis units in Brisbane (2018–2019) were screened for HTLV-1/2 antibodies using the Abbott ARCHITECT chemiluminescent microparticle immunoassay (CMIA) for antibodies against gp46-I, gp46-II and GD21 (Abbott CMIA, ARCHITECT). Reactive samples were confirmed through Western blot. Pooled Australian National Cancer Registry surveillance data reporting on cases coded for ATL (2004–2015) were analysed.Results Two out of 2000 hospital and health services samples were confirmed HTLV-1-positive (0.1%, 95% CI 0.02% to 0.4%), both in older women, one Indigenous and one non-Indigenous. All 540 haemodialysis samples tested negative for HTLV. All samples were HTLV-2-negative. Ten out of 42 (24.8%) reported cases of ATL in Australia were from Queensland (crude incidence rate 0.025/100 000; 95% CI 0.011 to 0.045); most cases were seen in adult men of non-Indigenous origin. Nineteen deaths due to ATL were recorded in Australia.Conclusion We confirm that HTLV-1 and ATL were detected in Queensland in Indigenous and non-Indigenous people. These results highlight the need for HTLV-1 prevalence studies in populations at risk of STIs to allow the implementation of focused public health sexual and mother-to-child transmission prevention strategies.