01946nas a2200265   4500000000100000008004100001260001300042653001500055653001000070653003000080653002200110653001100132653001200143653000900155653001500164653003000179100001200209700000900221245013400230856004100364300001200405490000700417520124200424022001401666       1995                            d  c1995 Jun10aAdolescent10aAdult10aDrug Therapy, Combination10aFollow-Up Studies10aHumans10aleprosy10aMale10aRecurrence10aWorld Health Organization1 aJamet P1 aJi B00aRelapse after long-term follow up of multibacillary patients treated by WHO multidrug regimen. Marchoux Chemotherapy Study Group.  uhttp://ila.ilsl.br/pdfs/v63n2a01.pdf  a195-2010 v633 a<p>Thirty-five multibacillary (MB) leprosy patients were treated with 2 years of multidrug therapy (MDT) and followed up regularly for relapse. Relapse was defined as: a) an increase of the bacterial index (BI) by 2+ over the previous value from any single site of old lesions and b) the occurrence of definite new skin lesion(s) which demonstrated a higher BI than any pre-existing lesion. After a mean duration of 72.7 +/- 17.3 months of follow up per patient, seven relapses were diagnosed; the mean incubation period of relapse was 62.7 +/- 18.7 months. The overall relapse rate was 20.0% (or 3.3 per 100 patient-years), very significantly higher than the figures obtained from the same group of patients analyzed 2 1/2 years earlier, indicating that relapses occurred late (at least 5 +/- 2 years) after stopping MDT. Further analysis indicated that the relapse rate was closely correlated with the bacterial load of the patient, occurring far more frequently among patients with a BI of &gt; or = 4.0 before MDT or with a BI of &gt; or = 3.0 at the end of MDT. To avoid the alarmingly high relapse rate, it is proposed that the duration of MDT be doubled to 4 years in patients with an average BI of &gt; or = 4.0 before MDT.</p>
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