Produção Nacional
Revisado por pares
Clinical and histological features of leprosy and human immunodeficiency virus co-infection in Brazil
2013; Oxford University Press; Volume: 38; Issue: 5 Linguagem: Inglês
10.1111/ced.12028
ISSN1365-2230
AutoresPatrícia Duarte Deps, Sebastian Lucas, Adriana María Porro, Solange M. Maeda, Jane Tomimori, Cássio Cesar Guidella, Tânia Reuter, Nayara Nunes de Oliveira, Brunela Pitanga Ramos Madureira, Vanda Akico Ueda Fick de Souza, Rafael Maffei Loureiro, Bruno Lima Alves, Andrea Bellone, Diana N.J. Lockwood,
Tópico(s)Syphilis Diagnosis and Treatment
ResumoBoth 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.
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