Type 1 reactions in leprosy, neuritis and steroid therapy: the impact of the human immunodeficiency virus

The incidence of type 1 reactions and neuritis among HIV seronegative and HIV seropositive leprosy patients was investigated. HIV seropositivity was associated with an increased incidence of type 1 reactions among multibacillary (MB) patients, which were observed in 9 of 12 seropositive MB patients and in 8 of 40 HIV seronegative MB patients (P < 0 · 0005). Similarly, the incidence of neuritis was significantly increased among the HIV seropositive MB patients, of whom 8 developed acute neuritis compared to 3 of the HIV seronegative patients (P < 0 · 0005). There was no significant difference between the numbers of paucibacillary HIV seropositive and HIV seronegative patients who developed these complications. Both the HIV seronegative and HIV seropositive patients showed a similar response to steroid therapy for the management of acute neuritis.