Background: Human T-lymphotropic virus type 1 (HTLV-1), a retrovirus, is the causative agent of HTLV-1-associated\nmyelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukaemia/lymphoma (ATLL). The reported\nassociation with pulmonary disease such as bronchiectasis is less certain.\nMethods: A retrospective case review of a HTLV-1 seropositive cohort attending a national referral centre. The\ncohort was categorised into HTLV-1 symptomatic patients (SPs) (ATLL, HAM/TSP, Strongyloidiasis and HTLV\nassociated inflammatory disease (HAID)) and HTLV-1 asymptomatic carriers (ACs). The cohort was reviewed for\ndiagnosis of bronchiectasis.\nResult: 34/246 ACs and 30/167 SPs had been investigated for respiratory symptoms by computer tomography (CT)\nwith productive cough +/- recurrent chest infections the predominant indications. Bronchiectasis was diagnosed in\none AC (1/246) and 13 SPs (2 HAID, 1 ATLL, 10 HAM/TSP) (13/167, RR 19.2 95 % CI 2.5-14.5, p = 0.004) with high\nresolution CT. In the multivariate analysis ethnicity (p = 0.02) and disease state (p < 0.001) were independent\npredictors for bronchiectasis. The relative risk of bronchiectasis in SPs was 19.2 (95 % CI 2.5-14.5, p = 0.004) and in\nHAM/TSP patients compared with all other categories 8.4 (95 % CI 2.7-26.1, p = 0.0002). Subjects not of\nAfrican/Afro-Caribbean ethnicity had an increased prevalence of bronchiectasis (RR 3.45 95 % 1.2-9.7, p = 0.02).\nConclusions: Bronchiectasis was common in the cohort (3.4 %). Risk factors were a prior diagnosis of HAM/TSP and\nethnicity but not HTLV-1 viral load, age and gender. The spectrum of HTLV-associated disease should now include\nbronchiectasis and HTLV serology should be considered in patients with unexplained bronchiectasis.
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