Conflict of interest: none declared.
Clinical Dermatology ● Original Article
Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil
Article first published online: 17 MAY 2013
© 2013 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 38, Issue 5, pages 470–477, July 2013
How to Cite
Deps, P., Lucas, S., Porro, A. M., Maeda, S. M., Tomimori, J., Guidella, C., Reuter, T., Oliveira, N. S., Madureira, B. P. R., Souza, V. A., Loureiro, R. M., Alves, B. L., Bellone, A. and Lockwood, D. N. J. (2013), Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil. Clinical and Experimental Dermatology, 38: 470–477. doi: 10.1111/ced.12028
- Issue published online: 18 JUN 2013
- Article first published online: 17 MAY 2013
- Manuscript Accepted: 20 DEC 2011
- Brazilian government (CAPES)
- FAPES/FUNCITEC. Grant Number: 45433798/09
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.
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.
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.
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.
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.