title: Two patients coinfected with Mycobacterium leprae and human immunodeficiency virus type 1 and naive for antiretroviral therapy who exhibited type 1 leprosy reactions mimicking the immune reconstitution inflammatory syndrome.
abstract: Two case reports of patients with human immunodeficiency virus type 1 (HIV-1) infection who developed leprosy are presented. Both developed type 1 leprosy reactions in the absence of antiretroviral therapy. Reactions have been described for a number of HIV-1- and Mycobacterium leprae-coinfected patients and have been considered to be part of an immune reconstitution inflammatory syndrome (IRIS) since the reactions were usually linked to the administration of highly active antiretroviral therapy. The reports of our two patients suggest that the type 1 reactions in patients with leprosy and HIV may not always be an IRIS manifestation but may be akin to the classical reactional state described for the natural course of leprosy infection, which occurs in leprosy patients due to the fluctuations of the antimycobacterial immune response, whether they are coinfected with HIV or not.
authors.affiliation: Department of Dermatology, Medical School of the University of São Paulo, Rua Cristiano Viana 450, ap. 163, São Paulo CEP 05411-000, Brazil. angelatrindade@uol.com.br
authors.forename: M A B
authors.initials: MA
authors.lastname: Trindade
authors.forename: N Y S
authors.initials: NY
authors.lastname: Valente
authors.forename: M I P
authors.initials: MI
authors.lastname: Manini
authors.forename: M D F
authors.initials: MD
authors.lastname: Takahashi
authors.forename: C F D
authors.initials: CF
authors.lastname: Anjos
authors.forename: G
authors.initials: G
authors.lastname: Benard
authors.forename: B
authors.initials: B
authors.lastname: Naafs
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001938:Brazil; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D015497:HIV-1; D006651:Histocytochemistry; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D007918:Leprosy / Q000150:complications / Q000276:immunology* / Q000382:microbiology / Q000473:pathology; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000276:immunology; D012867:Skin / Q000473:pathology
chemical_list: D019380:Anti-HIV Agents; D007917:Leprostatic Agents