Clinical and histological features of leprosy and human immunodeficiency virus co‐infection in Brazil. (17th May 2013)

• Record Type: Journal Article
• Authors: Deps, P.; Lucas, S.; Porro, A. M.; Maeda, S. M.; Tomimori, J.; Guidella, C.; Reuter, T.; Oliveira, N. S.; Madureira, B. P. R.; Souza, V. A.; Loureiro, R. M.; Alves, B. L.; Bellone, A.; Lockwood, D. N. J.
• Is Part Of: Clinical and experimental dermatology. Volume 38:Number 5(2013)
• Page Start: 470
• Page End: 477
• Publication Date: 2013-05-17
• Subjects: Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/ced.12028
• Languages: English
• ISSNs: 0307-6938

Abstract

<abstract abstract-type="main" id="ced12028-abs-0001"> <title>Summary</title> <sec id="ced12028-sec-0001" sec-type="section"> <title>Background</title> <p>Both leprosy and human immunodeficiency virus (HIV) are infectious diseases, and are an important global health problem. Patients with leprosy who are co‐infected with HIV seem to be at higher risk of developing leprosy reactions.</p> </sec> <sec id="ced12028-sec-0002" sec-type="section"> <title>Aim</title> <p>To examine the histological features of leprosy in patients with HIV and leprosy co‐infection, particularly to determine whether the typical leprosy histopathology is present in skin biopsies, and to assess the histological features of leprosy reactions in co‐infected patients.</p> </sec> <sec id="ced12028-sec-0003" sec-type="section"> <title>Methods</title> <p>This was a matched cohort study with 11 co‐infected patients and 31 HIV‐negative patients with leprosy. A structured protocol for skin‐biopsy evaluation was followed, focusing on inflammation of the skin and dermal nerves.</p> </sec> <sec id="ced12028-sec-0004" sec-type="section"> <title>Results</title> <p>Of the 11 HIV‐positive patients, 7 (63%) had borderline tuberculoid (BT) leprosy and 5 (70%) of these 7 patients had developed a type 1 reaction. The lesions in these patients were immunologically active, with 100% of biopsies having evidence of compact granulomas, 90% evidence of oedema and 30% evidence of necrosis.</p> </sec> <sec id="ced12028-sec-0005" sec-type="section"> <title>Conclusions</title> <p>In this study, patients co‐infected with HIV and <italic>M. leprae</italic> had the typical histological lesions of leprosy. There was evidence of immune activation in patients who received combination antiretroviral therapy, and these patients had BT leprosy and leprosy‐upgrading reactions.</p> </sec> </abstract>