02282nas a2200361   4500000000100000008004100001260001300042653001000055653002600065653001100091653002500102653001900127653001600146653001500162653001100177653001900188653001000207653001100217653001200228653000900240653002500249100001400274700001400288700002100302700001400323700001400337700001500351245018100366300001100547490000700558520134100565022001401906       2004                            d  c2004 Nov10aAdult10aAntibodies, Bacterial10aBrazil10aCD4 Lymphocyte Count10aCohort Studies10aComorbidity10aDNA, Viral10aFemale10aHIV Infections10aHIV-110aHumans10aleprosy10aMale10aMycobacterium leprae1 aPereira G1 aStefani M1 aAraújo Filho JA1 aSouza LCS1 aStefani G1 aMartelli C00aHuman immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic, and histopathologic profiles in a Brazilian cohort.  a679-840 v713 a<p>Co-infections with human immunodeficiency virus (HIV) and Mycobacterium leprae represent unique opportunities to investigate the interaction of both pathogens. We determined the immunologic, virologic, and histopathologic characteristics of 22 co-infected Brazilian patients (median age = 38 years, 81.8% males, 72.2% with paucibacillary leprosy, and 95.4% with acquired immunodeficiency syndrome). The HIV-1 subtypes B and BF predominated in envelope and gag heteroduplex mobility analysis. Borderline tuberculoid (BT), tuberculoid, lepromatous, and indeterminate morphology with CD3+, CD8+, and CD68+ cell distributions compatible with leprosy patients not infected with HIV were observed. Histologic evidence of nerve damage was observed in BT lesions. IgM antibody to M. leprae-specific phenolic glycolipid I was not detected. Two of six co-infected patients monitored during highly active antiretroviral therapy (HAART) developed a leprosy type 1 reaction after an increase in CD4+ cells, suggesting an immune restoration phenomenon. Clinical, immunologic, histopathologic, and virologic features among these HIV-leprosy co-infected patients indicate that each disease progressed as in single infection. However, HAART immune reconstitution may trigger potential adverse effects, such as leprosy acute inflammatory episodes.</p>  a0002-9637