02833nas a2200433   4500000000100000008004100001260001300042653001000055653000900065653002500074653001900099653001600118653002500134653002400159653001300183653001100196653001100207653002300218653001200241653000900253653001600262653002600278653001500304653001400319653002400333653001700357653003000374653001800404100001700422700001200439700001200451245009000463856005900553300001100612490000700623050003200630520172300662022001402385       2000                            d  c2000 Sep10aAdult10aAged10aAnalysis of Variance10aCohort Studies10aComorbidity10aConfidence Intervals10aDisease Progression10aEthiopia10aFemale10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aMultivariate Analysis10aPrevalence10aPrognosis10aProspective Studies10aRisk Factors10aSeverity of Illness Index10aSkin Diseases1 aSaunderson P1 aGebre S1 aByass P00aReversal reactions in the skin lesions of AMFES patients: incidence and risk factors.  uhttp://leprev.ilsl.br/pdfs/2000/v71n3/pdf/v71n3a10.pdf  a309-170 v71  aInfolep Library - available3 a<p>Reversal reactions affect the skin and/or nerves of leprosy patients. This paper looks at reversal reactions involving the skin in 594 new patients in central Ethiopia, followed for between 6 and 11 years after the start of treatment. The incidence of reversal reaction declines steadily after the start of treatment, but the first episode may occur as long as 5 years after diagnosis in both paucibacillary (PB) and multibacillary (MB) patients. Recurrent episodes occurred up to 6 years after diagnosis. PB patients were at greatest risk for reversal reaction in the first year after diagnosis and MB patients in the first 4 years. The highest incidence rate was 18 episodes per 100 person years in MB patients during the first year after diagnosis. The ratio of the incidence rates for the first 3 years in MB versus PB patients is 2.4 (95% CI 1.6-3.8). This study confirms that starting effective treatment and borderline classification are risk factors for reversal reactions. Pregnancy/delivery in the 6 months prior to diagnosis was a significant risk factor for presenting with a reversal reaction [relative risk (RR) 5.9 (95% CI 2.1-16.5)], but later pregnancies were not associated with an increased risk. Being female was a significant risk factor for the late appearance of the first episode of reversal reaction. Having a reversal reaction in the first year after diagnosis was a highly significant risk factor for the development of later reactions [RR in PB cases 11.9 (95% CI 3.4-41.7); in MB cases 6.4 (95% CI 3.8-10.6)]. Being HIV positive was a risk factor for developing recurrent reversal reactions, although only three out of 29 recurrent cases were HIV positive [RR 2.7 (95% CI 1.4-5.1)].</p>  a0305-7518