title: Leprosy and HIV coinfection: a clinical, pathological, immunological, and therapeutic study of a cohort from a Brazilian referral center for infectious diseases.
abstract: BACKGROUND
  Although awareness of the relevance of leprosy and human immunodeficiency virus (HIV) coinfection is increasing worldwide, several aspects of this co-occurrence are not fully understood.
  
  
  METHODS
  We describe clinical, pathological, immunological, and therapeutic long-term follow-up of a cohort of 25 individuals with leprosy and HIV infection from Manaus, Amazonas.
  
  
  RESULTS
  Careful description of our cohort indicates a higher prevalence of leprosy in an HIV-positive population than that in the general population. We also observed upgrading shifting of leprosy clinical forms after initiation of highly active antiretroviral therapy and multidrug therapy and an impact of HIV infection on leprosy granuloma formation, among other features.
  
  
  CONCLUSIONS
  Taken together, these new insights allow the proposition of a classification system that includes (1) leprosy and HIV true coinfection, (2) opportunistic leprosy disease, and (3) leprosy related to highly active antiretroviral therapy.
authors.affiliation: Department of Dermatology, Tropical Medicine Foundation of Amazonas, Manaus, Amazonas, Brazil. carolinatalhari@gmail.com
authors.forename: Carolina
authors.initials: C
authors.lastname: Talhari
authors.forename: Marcelo Távora
authors.initials: MT
authors.lastname: Mira
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: Andréa
authors.initials: A
authors.lastname: Braga
authors.forename: Anette
authors.initials: A
authors.lastname: Chrusciak-Talhari
authors.forename: Mônica
authors.initials: M
authors.lastname: Santos
authors.forename: Ana Tereza
authors.initials: AT
authors.lastname: Orsi
authors.forename: Christiane
authors.initials: C
authors.lastname: Matsuo
authors.forename: Renata
authors.initials: R
authors.lastname: Rabelo
authors.forename: Lisiane
authors.initials: L
authors.lastname: Nogueira
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: de Lima Ferreira
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ribeiro-Rodrigues
authors.forename: Sinésio
authors.initials: S
authors.lastname: Talhari
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D006099:Granuloma / Q000473:pathology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents