Leprosy and AIDS: two cases of increasing inflammatory reactions at the start of highly active antiretroviral therapy.
Reported here are the cases of two HIV-positive patients with skin lesions suggestive of leprosy, based on clinical and pathological analysis, which worsened during the few weeks following initiation of highly active antiretroviral therapy. The lesions improved after a few weeks of multidrug therapy for leprosy. Mycobacterium leprae was confirmed by polymerase chain reaction analysis of blood in case 1 and of a biopsy sample in case 2. Neither Mycobacterium avium complex nucleic acid, which is usually associated with immune restoration syndrome, nor mycobacterial cutaneous manifestations were detected in either case.
Pignataro
P
P
Leprosy Laboratory, Department of Tropical Medicine, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, CEP 21045-900 Rio de Janeiro, Brazil. pignatp@ioc.fiocruz.br
Rocha
A da Silva
Ada S
Nery
J A C
JA
Miranda
A
A
Sales
A M
AM
Ferrreira
H
H
Valentim
V
V
Suffys
P N
PN
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000209:etiology; D007249:Inflammation / Q000209:etiology*; D007918:Leprosy / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae