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Higher human T‐cell leukaemia virus type 1 (HTLV‐1) proviral load is associated with end‐stage kidney disease in Indigenous Australians: Results of a case‐control study in central Australia
Author(s) -
Talukder Mohammad Radwanur R.,
Walley Rebecca,
Pham Hai,
Schinke Shane,
Woodman Richard,
Wilson Kim,
Sajiv Cherian,
Einsiedel Lloyd
Publication year - 2019
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.25532
Subject(s) - medicine , kidney disease , asymptomatic , odds ratio , diabetes mellitus , gastroenterology , virology , endocrinology
Case series suggest that human T‐cell leukaemia virus type 1 (HTLV‐1) is associated with kidney disease; however, little is known about the impact of proviral load (PVL). The present study was commenced to determine whether higher HTLV‐1 PVL is associated with end stage kidney disease (ESKD) in Indigenous Australians. A case‐control study was conducted in Alice Springs Hospital (ASH), 1 July 2007 to 30 November 2015. Cases included all 80 Indigenous adults (>17 years) with HTLV‐1c and ESKD, matched 1:1 by sex to controls with HTLV‐1 who had no renal disease or other recognised disease associations of HTLV‐1, and were recruited during the same period. The association between PVL and ESKD was assessed using logistic regression. Median (IQR) HTLV‐1c PVL for subjects with ESKD (6.86, IQR (3.35, 8.23) log copies per 10 5 peripheral blood leukocytes (PBL) (ie, 0.95; IQR, 0.03; 3.70% PBL) was significantly higher than that of the asymptomatic group (3.47; IQR (−0.04, 6.61) log copies per 10 5 PBL (ie, 0.01; IQR, 0.00; 0.52% PBL) (asymptomatic vs ESKD, P (ranksum) < .001). Major factors associated with ESKD were diabetes (adjusted odds ratio [aOR], 21.80; 95% CI, 4.84, 98.22; P < .001), hypertension (aOR, 4.16; 1.11, 15.64; P = .03), remote residence (aOR, 5.34; 95% CI, 1.17, 27.29; P = .03) and HTLV‐1c PVL greater than or equal to 100 copies per 10 5 PBL (aOR, 3.67; 95% CI, 1.36, 9.92; P = .01). Higher HTLV‐1c PVL are strongly associated with inflammatory diseases. The high HTLV‐1c PVL reported here may have clinical implications for people with HTLV‐1 who require haemodialysis. Longitudinal studies are required to determine whether this association is causal.