02713nas a2200253   4500000000100000008004100001100001100042700001600053700001300069700001400082700001900096700001600115700001600131700001200147700001300159700001500172700002200187245008200209856007900291300000800370490000700378520206000385022001402445       2018                            d1 aGama R1 aGomides TAR1 aGama CFM1 aMoreira S1 aNeves Manta FS1 aOliveira LB1 aMarçal PHF1 aSarno E1 aMoraes M1 aGarcia RMG1 aOliveira Fraga LA00aHigh frequency of M. leprae DNA detection in asymptomatic household contacts.  uhttps://bmcinfectdis.biomedcentral.com/track/pdf/10.1186/s12879-018-3056-2  a1530 v183 a<p><strong>BACKGROUND: </strong>Characterization of the Mycobacterium leprae genome has made possible the development of Polymerase Chain Reaction (PCR) systems that can amplify different genomic regions. Increased reliability and technical efficiency of quantitative PCR (qPCR) makes it a promising tool for early diagnosis of leprosy. Index cases that are multibacillary spread the bacillus silently, even before they are clinically diagnosed. Early detection and treatment could prevent transmission in endemic areas.</p>

<p><strong>METHODS: </strong>In this study, the qPCR technique is used to detect DNA of M. leprae in samples of slit skin smears (SSS) of the ear lobe and blood of leprosy patients and their asymptomatic household contacts residing in Governador Valadares, MG, Brazil, a hyperendemic area for leprosy. A total of 164 subjects participated in the study: 43 index cases, 113 household contacts, and, as negative controls, 8 individuals who reported no contact with patients nor history of leprosy in the family. The qPCR was performed to amplify 16S rRNA fragments and was specifically designed for M. leprae.</p>

<p><strong>RESULTS: </strong>Of asymptomatic household contacts, 23.89% showed bacillary DNA by qPCR in samples of SSS and blood. Also, 48.84% of patients diagnosed with leprosy were positive for qPCR while the bacillary load was positive in only 30.23% of patients. It is important to note that most patients were already receiving treatment when the collection of biological material for qPCR was performed. The level of bacillary DNA from household contacts was similar to the DNA levels detected in the group of paucibacillary patients.</p>

<p><strong>CONCLUSION: </strong>Considering that household contacts comprise a recognizable group of individuals with a high risk of disease, as they live in close proximity to a source of infection, qPCR can be used to estimate the risk of progress towards leprosy among household contacts and as a routine screening method for a chemoprophylactic protocol.</p>
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