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.
journal_name
Clin Exp Dermatoljournal_title
Clinical and experimental dermatologyauthors
Deps P,Lucas S,Porro AM,Maeda SM,Tomimori J,Guidella C,Reuter T,Oliveira NS,Madureira BP,Souza VA,Loureiro RM,Alves BL,Bellone A,Lockwood DNdoi
10.1111/ced.12028subject
Has Abstractpub_date
2013-07-01 00:00:00pages
470-7issue
5eissn
0307-6938issn
1365-2230journal_volume
38pub_type
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