|Title||Leprosy and HIV coinfection: a critical approach.|
|Publication Type||Journal Article|
|Authors||Massone C, Talhari C, Ribeiro-Rodrigues R, Sindeaux RHM, Mira MT, Talhari S, Naafs B|
|Abbrev. Journal||Expert Rev Anti Infect Ther|
|Journal||Expert review of anti-infective therapy|
|Year of Publication||2011|
|Keywords||Anti-Bacterial Agents, Antiretroviral Therapy, Highly Active, Antiviral Agents, Comorbidity, HIV, HIV Infections, Humans, Immune Reconstitution Inflammatory Syndrome, Incidence, Leprosy, Mycobacterium leprae, Mycobacterium tuberculosis, Species Specificity, Tuberculosis|
An increase in leprosy among HIV patients, similar to that observed in patients with TB, was expected approximately 20 years ago. Studies conducted in the 1990s together with those reported recently seemed to indicate that a coinfection with HIV did not alter the incidence and the clinical spectrum of leprosy and that each disease progressed as a single infection. By contrast, in countries with a high seroprevalence of HIV, TB was noted to increase. Explanations may be provided by the differences in the incubation time, the biology and toxicity of Mycobacterium leprae and Mycobacterium tuberculosis. After the introduction of HAART the leprosy-HIV coinfection manifested itself as an immune reconstitution inflammatory syndrome (IRIS), typically as paucibacillary leprosy with type 1 leprosy reaction. The incidence of leprosy in HIV-infected patients has never been properly investigated. IRIS-leprosy is probably underestimated and recent data showed that the incidence of leprosy in HIV patients under HAART was higher than previously thought.