Association between anti-pGL-I IgM and clinical and demographic parameters in leprosy.

OBJECTIVE: To determine the risk factors and clinical significance of anti-PGL-I seropositivity.

DESIGN: A large-scale sero-epidemiological study (COLEP) was carried out in northwest Bangladesh. Blood on filter paper from 1025 newly diagnosed patients was collected before treatment was started and tested with an anti-PGL-I ELISA; the relation between patient determinants and seropositivity was calculated using logistic regression.

RESULTS: The median age was 30 years and the male:female ratio 1.9. Overall, 342 patients (33.4%) were seropositive. The following determinants showed a significant correlation with seropositivity (P < 0-05) in multivariate analysis: sex, age, disability grade, bacterial index and classification according to the World Health Organization (WHO) system. The number and extent of clinical signs correlated with seropositivity, except for the presence of satellite lesions. People with or without a BCG vaccination scar had a similar risk to be seropositive.

CONCLUSION: Serology is a marker for a higher systemic bacterial load and may identify potential infectious sources among patients with few clinical signs. The size of skin lesions was positively correlated with seropositivity. We did not find different levels of seropositivity among patients with one or two skin lesions, neither did we find different levels among patients with or without satellite