Human Immunodeficiency Virus and Leprosy Coinfection: Challenges in Resource-Limited Setups

• Published in: Case Reports in Medicine 2012-01, Vol.2012 (2012), p.207-211-254
• Main Authors: Kwobah, Charles M., Wools-Kaloustian, Kara K., Gitau, Jane N., Siika, Abraham M.
• Format: Article
• Language: English
• Subjects: Case Report
• ISSN: 1687-9627; 1687-9635
• DOI: 10.1155/2012/698513

Mycobacteria leprae(leprosy) and HIV coinfection are rare in Kenya. This is likely related to the low prevalence (1 per 10,000 of population) of leprosy. Because leprosy is no longer a public health challenge there is generally a low index of suspicion amongst clinicians for its diagnosis. Management of a HIV-1-leprosy-coinfected individual in a resource-constrained setting is challenging. Some of these challenges include difficulties in establishing a diagnosis of leprosy; the high pill burden of cotreatment with both antileprosy and antiretroviral drugs (ARVs); medications’ side effects; drug interactions; scarcity of drug choices for both diseases. This challenge is more profound when managing a patient who requires second-line antiretroviral therapy (ART). We present an adult male patient coinfected with HIV and leprosy, who failed first-line antiretroviral therapy (ART) and required second-line treatment. Due to limited choices in antileprosy drugs available, the patient received monthly rifampicin and daily lopinavir-/ritonavir-based antileprosy and ART regimens, respectively. Six months into his cotreatment, he seemed to have adequate virological control. This case report highlights the challenges of managing such a patient.