@article{24088,
  keywords = {Adult, Aged, Brazil, CD4 Lymphocyte Count, Cohort Studies, Coinfection, Female, HIV Infections, Humans, leprosy, Male, Middle Aged, Young Adult},
  author = {Deps P and Lucas S and Porro A M and Maeda S M and Tomimori J and Guidella C and Reuter T and Oliveira N S and Madureira B P R and Souza V A and Loureiro R M and Alves B L and Bellone A and Lockwood DN},
  title = {Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil.},
  abstract = {<p><b>BACKGROUND: </b>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><p><b>AIM: </b>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><p><b>METHODS: </b>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><p><b>RESULTS: </b>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><p><b>CONCLUSIONS: </b>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.</p>},
  year = {2013},
  journal = {Clinical and experimental dermatology},
  volume = {38},
  pages = {470-7},
  month = {2013 Jul},
  issn = {1365-2230},
  doi = {10.1111/ced.12028},
  language = {eng},
}