Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil

Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil

Author Deps, P. Google Scholar
Lucas, S. Google Scholar
Porro, A. M. Autor UNIFESP Google Scholar
Maeda, S. M. Autor UNIFESP Google Scholar
Tomimori, J. Autor UNIFESP Google Scholar
Guidella, C. Google Scholar
Reuter, T. Google Scholar
Oliveira, N. S. Google Scholar
Madureira, B. P. R. Google Scholar
Souza, V. A. Google Scholar
Loureiro, R. M. Google Scholar
Alves, B. L. Google Scholar
Bellone, A. Google Scholar
Lockwood, D. N. J. Google Scholar
Institution Univ Fed Espirito Santo
Guys & St Thomas Hosp NHS Fdn Trust
Universidade Federal de São Paulo (UNIFESP)
Ctr Sanit Dermatol
Universidade de São Paulo (USP)
Hosp Trop Dis
Abstract Background 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. Aim 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. Methods 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. Results 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. Conclusions in this study, patients co-infected with HIV and M.leprae 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.
Language English
Sponsor Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
La Roche-Posay Latin America Foundation
FAPES/FUNCITEC
Grant number FAPES/FUNCITEC: 45433798/09
Date 2013-07-01
Published in Clinical and Experimental Dermatology. Hoboken: Wiley-Blackwell, v. 38, n. 5, p. 470-477, 2013.
ISSN 0307-6938 (Sherpa/Romeo, impact factor)
Publisher Wiley-Blackwell
Extent 470-477
Origin http://dx.doi.org/10.1111/ced.12028
Access rights Closed access
Type Article
Web of Science ID WOS:000320545000004
URI http://repositorio.unifesp.br/handle/11600/36518

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