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Publication

Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil.

Abstract

BACKGROUND: Both leprosy and human immunodeficiency virus (HIV) are infectious diseases, and are an important global health problem. Patients with leprosy who are co-infected with HIV seem to be at higher risk of developing leprosy reactions.

AIM: To examine the histological features of leprosy in patients with HIV and leprosy co-infection, particularly to determine whether the typical leprosy histopathology is present in skin biopsies, and to assess the histological features of leprosy reactions in co-infected patients.

METHODS: This was a matched cohort study with 11 co-infected patients and 31 HIV-negative patients with leprosy. A structured protocol for skin-biopsy evaluation was followed, focusing on inflammation of the skin and dermal nerves.

RESULTS: Of the 11 HIV-positive patients, 7 (63%) had borderline tuberculoid (BT) leprosy and 5 (70%) of these 7 patients had developed a type 1 reaction. The lesions in these patients were immunologically active, with 100% of biopsies having evidence of compact granulomas, 90% evidence of oedema and 30% evidence of necrosis.

CONCLUSIONS: In this study, patients co-infected with HIV and M. leprae had the typical histological lesions of leprosy. There was evidence of immune activation in patients who received combination antiretroviral therapy, and these patients had BT leprosy and leprosy-upgrading reactions.

More information

Type
Journal Article
Author
Deps P
Lucas S
Porro A M
Maeda S M
Tomimori J
Guidella C
Reuter T
Oliveira N S
Madureira B P R
Souza V A
Loureiro R M
Alves B L
Bellone A
Lockwood D N J
Year of Publication
2013
Journal
Clinical and experimental dermatology
Volume
38
Issue
5
Number of Pages
470-7
Date Published
2013 Jul
Language
eng
ISSN Number
1365-2230
Call Number
DEPS 2013
DOI
10.1111/ced.12028
Alternate Journal
Clin. Exp. Dermatol.
Publication Language
eng