02106nas a2200277   4500000000100000008004100001260001300042653001600055653002400071653002200095653001600117653001600133653001100149653001200160653001700172100001400189700001400203700001300217245012200230856004800352300000900400490001600409050001700425520137200442022001401814       2012                            d  c2012 Dec10aCoinfection10aDisease Progression10aHTLV-I Infections10aHepatitis B10aHepatitis C10aHumans10aleprosy10aRisk Factors1 aMachado P1 aJohnson W1 aGlesby M00aThe role of human T cell lymphotrophic virus type 1, hepatitis B virus and hepatitis C virus coinfections in leprosy.  uhttp://www.scielo.br/pdf/mioc/v107s1/08.pdf  a43-80 v107 Suppl 1  aMACHADO 20123 a<p>Leprosy spectrum and outcome is associated with the host immune response against Mycobacterium leprae. The role of coinfections in leprosy patients may be related to a depression of cellular immunity or amplification of inflammatory responses. Leprosy remains endemic in several regions where human T cell lymphotrophic virus type 1 (HTLV-1), hepatitis B virus (HBV) or hepatitis C virus (HCV) are also endemic. We have evaluated the evidence for the possible role of these viruses in the clinical manifestations and outcomes of leprosy. HTLV-1, HBV and HCV are associated with leprosy in some regions and institutionalization is an important risk factor for these viral coinfections. Some studies show a higher prevalence of viral coinfection in lepromatous cases. Although HBV and HCV coinfection were associated with reversal reaction in one study, there is a lack of information about the consequences of viral coinfections in leprosy. It is not known whether clinical outcomes associated with leprosy, such as development of reactions or relapses could be attributed to a specific viral coinfection. Furthermore, whether the leprosy subtype may influence the progression of the viral coinfection is unknown. All of these important and intriguing questions await prospective studies to definitively establish the actual relationship between these entities.</p>  a1678-8060