Leprosy and HIV Coinfection: A Clinical, Pathological, Immunological, and Therapeutic Study of a Cohort from a Brazilian Referral Center for Infectious Diseases

• Published in: The Journal of infectious diseases 2010-08, Vol.202 (3), p.345-354
• Main Authors: Talhari, Carolina, Mira, Marcelo Távora, Massone, Cesare, Braga, Andréa, Chrusciak-Talhari, Anette, Santos, Mônica, Orsi, Tereza Ana, Matsuo, Christiane, Rabelo, Renata, Nogueira, Lisiane, de Lima Ferreira, Luiz Carlos, Ribeiro-Rodrigues, Rodrigo, Talhari, Sinésio
• Format: Article
• Language: English
• Subjects: Adult; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Bacterial diseases; Biological and medical sciences; Bleeding time; Brazil - epidemiology; Cohort Studies; Coinfection; Comorbidity; Fundamental and applied biological sciences. Psychology; Granuloma - pathology; Highly active antiretroviral therapy; HIV; HIV infections; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - immunology; HIV Infections - pathology; HIV/AIDS; Human bacterial diseases; Humans; Infectious diseases; Leprosy; Leprosy - complications; Leprosy - drug therapy; Leprosy - epidemiology; Leprosy - immunology; Leprosy - pathology; Lesions; Longitudinal Studies; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Paucibacillary leprosy; Prevalence; Severity of Illness Index; T lymphocytes; Tropical bacterial diseases; Virology; Young Adult
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/653839

Background. Although awareness of the relevance of leprosy and human immunodeficiency virus (HIV) coinfection is increasing worldwide, several aspects of this co-occurrence are not fully understood. Methods. We describe clinical, pathological, immunological, and therapeutic long-term follow-up of a cohort of 25 individuals with leprosy and HIV infection from Manaus, Amazonas. Results. Careful description of our cohort indicates a higher prevalence of leprosy in an HIV-positive population than that in the general population. We also observed upgrading shifting of leprosy clinical forms after initiation of highly active antiretroviral therapy and multidrug therapy and an impact of HIV infection on leprosy granuloma formation, among other features. Conclusion. Taken together, these new insights allow the proposition of a classification system that includes (1) leprosy and HIV true coinfection, (2) opportunistic leprosy disease, and (3) leprosy related to highly active antiretroviral therapy.