Human T Cell Leukaemia Virus type 1 (HTLV-1)

• The Human T Cell Leukaemia Virus type 1 (HTLV-1) is a human retrovirus that seems to be associated with clinical disease in approximately 10% of people infected — the vast majority will never develop symptoms
• HTLV-1 is the recognised cause of adult T cell leukaemia/lymphoma (ATL) and HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP)
• HTLV-1 is also associated with inflammatory diseases including bronchiectasis, uveitis, infective dermatitis and severe infections with strongyloides, stercoralis and scabies

Assessment

• Consider HTLV-1 in an Indigenous person with
• Progressive difficulties with walking or passing urine
• Chronic lung disease — see bronchiolitis
• Frequent infective dermatitis 
• Review previous specialist assessments and hospital admissions — check if previous testing for HTLV-1
• Medical consult

Ask

• About anyone else in the family with similar problem

Check

• Full adult health check — including medical consult for gait and neurological examination

Do

• Medical consult for referral to infectious disease specialist

Follow-up

• Reinforce safe sex messages and advise not to share razors or needles — to prevent spread of HTLV-1 infection
• Specialist advice for
• Care plan
• Frequent or unresolving skin and lung infections 
• Breastfeeding women with HTLV-1 — may be advised to cease breastfeeding after 6 months depending on capacity to provide safe alternatives and risk of transmission