Human immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic, and histopathologic profiles in a Brazilian cohort.

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TitleHuman immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic, and histopathologic profiles in a Brazilian cohort.
Publication TypeJournal Article
AuthorsPereira GAS, Stefani MMA, Araújo Filho JA, Souza LCS, Stefani GP, Martelli CMT
Abbrev. JournalAm. J. Trop. Med. Hyg.
JournalThe American journal of tropical medicine and hygiene
Year of Publication2004
Volume71
Issue5
Pagination679-84
Publication Languageeng
KeywordsAdult, Antibodies, Bacterial, Brazil, CD4 Lymphocyte Count, Cohort Studies, Comorbidity, DNA, Viral, Female, HIV Infections, HIV-1, Humans, Leprosy, Male, Mycobacterium leprae
Abstract

Co-infections with human immunodeficiency virus (HIV) and Mycobacterium leprae represent unique opportunities to investigate the interaction of both pathogens. We determined the immunologic, virologic, and histopathologic characteristics of 22 co-infected Brazilian patients (median age = 38 years, 81.8% males, 72.2% with paucibacillary leprosy, and 95.4% with acquired immunodeficiency syndrome). The HIV-1 subtypes B and BF predominated in envelope and gag heteroduplex mobility analysis. Borderline tuberculoid (BT), tuberculoid, lepromatous, and indeterminate morphology with CD3+, CD8+, and CD68+ cell distributions compatible with leprosy patients not infected with HIV were observed. Histologic evidence of nerve damage was observed in BT lesions. IgM antibody to M. leprae-specific phenolic glycolipid I was not detected. Two of six co-infected patients monitored during highly active antiretroviral therapy (HAART) developed a leprosy type 1 reaction after an increase in CD4+ cells, suggesting an immune restoration phenomenon. Clinical, immunologic, histopathologic, and virologic features among these HIV-leprosy co-infected patients indicate that each disease progressed as in single infection. However, HAART immune reconstitution may trigger potential adverse effects, such as leprosy acute inflammatory episodes.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/15569804?dopt=Abstract