title: Human immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic, and histopathologic profiles in a Brazilian cohort.
abstract: Co-infections with human immunodeficiency virus (HIV) and Mycobacterium leprae represent unique opportunities to investigate the interaction of both pathogens. We determined the immunologic, virologic, and histopathologic characteristics of 22 co-infected Brazilian patients (median age = 38 years, 81.8% males, 72.2% with paucibacillary leprosy, and 95.4% with acquired immunodeficiency syndrome). The HIV-1 subtypes B and BF predominated in envelope and gag heteroduplex mobility analysis. Borderline tuberculoid (BT), tuberculoid, lepromatous, and indeterminate morphology with CD3+, CD8+, and CD68+ cell distributions compatible with leprosy patients not infected with HIV were observed. Histologic evidence of nerve damage was observed in BT lesions. IgM antibody to M. leprae-specific phenolic glycolipid I was not detected. Two of six co-infected patients monitored during highly active antiretroviral therapy (HAART) developed a leprosy type 1 reaction after an increase in CD4+ cells, suggesting an immune restoration phenomenon. Clinical, immunologic, histopathologic, and virologic features among these HIV-leprosy co-infected patients indicate that each disease progressed as in single infection. However, HAART immune reconstitution may trigger potential adverse effects, such as leprosy acute inflammatory episodes.
authors.affiliation: Tropical Pathology and Public Health Institute, Federal University of Goiás, Rua Delenda Rezende de Melo, s/n Setor Universitario, 74 605 050 Goiânia-Goiás, Brazil. gisner@terra.com.br
authors.forename: Gisner A S
authors.initials: GA
authors.lastname: Pereira
authors.forename: Mariane M A
authors.initials: MM
authors.lastname: Stefani
authors.forename: João A
authors.initials: JA
authors.lastname: Araújo Filho
authors.forename: Luís Carlos S
authors.initials: LC
authors.lastname: Souza
authors.forename: Germana P
authors.initials: GP
authors.lastname: Stefani
authors.forename: Celina M T
authors.initials: CM
authors.lastname: Martelli
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015897:Comorbidity; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007918:Leprosy / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D008297:Male; D009166:Mycobacterium leprae / Q000276:immunology / Q000302:isolation & purification
chemical_list: D000907:Antibodies, Bacterial; D004279:DNA, Viral