Mycobacterium leprae DNA associated with type 1 reactions in single lesion paucibacillary leprosy treated with single dose rifampin, ofloxacin, and minocycline.
Leprosy affects skin and peripheral nerves, and acute inflammatory type 1 reactions (reversal reaction) can cause neurologic impairment and disabilities. Single skin lesion paucibacillary leprosy volunteers (N = 135) recruited in three Brazilian endemic regions, treated with single-dose rifampin, ofloxacin, and minocycline (ROM), were monitored for 3 years. Poor outcome was defined as type 1 reactions with or without neuritis. IgM anti-phenolic glycolipid I, histopathology, Mitsuda test, and Mycobacterium leprae DNA polymerase chain reaction (ML-PCR) were performed at baseline. chi(2) test, Kaplan-Meir curves, and Cox proportional hazards were applied. The majority of volunteers were adults with a mean age of 30.5 +/- 15.4 years; 44.4% were ML-PCR positive. During follow-up, 14.8% of the patients had a poor clinical outcome, classified as a type 1 reaction. Older age (> or = 40 years), ML-PCR positivity, and lesion size > 5 cm were associated with increased risk. In multivariate analysis, age (> or = 40 years) and ML-PCR positivity remained baseline predictors of type 1 reaction among monolesion leprosy patients.
Sousa
Ana Lucia O M
AL
Tropical Pathology and Public Health Institute, Federal University of Goias, Goiania, Goias, Brazil. almaroclo@dm.com.br
Stefani
Mariane M A
MM
Pereira
Gisner A S
GA
Costa
Mauricio B
MB
Rebello
Paula F
PF
Gomes
Maria Katia
MK
Narahashi
Kazue
K
Gillis
Thomas P
TP
Krahenbuhl
James L
JL
Martelli
Celina M T
CM
D000293:Adolescent; D000328:Adult; D000375:Aging; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000302:isolation & purification*; D004893:Erythema Nodosum / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007918:Leprosy / Q000188:drug therapy* / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use*; D009166:Mycobacterium leprae / Q000302:isolation & purification*; D015242:Ofloxacin / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D012293:Rifampin / Q000627:therapeutic use*; D012307:Risk Factors; D013997:Time Factors
D004269:DNA, Bacterial; D015242:Ofloxacin; D008911:Minocycline; D012293:Rifampin