@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},
}