Leprosy and HIV coinfection: a clinical, pathological, immunological, and therapeutic study of a cohort from a Brazilian referral center for infectious diseases.
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.
Talhari
Carolina
C
Department of Dermatology, Tropical Medicine Foundation of Amazonas, Manaus, Amazonas, Brazil. carolinatalhari@gmail.com
Mira
Marcelo Távora
MT
Massone
Cesare
C
Braga
Andréa
A
Chrusciak-Talhari
Anette
A
Santos
Mônica
M
Orsi
Ana Tereza
AT
Matsuo
Christiane
C
Rabelo
Renata
R
Nogueira
Lisiane
L
de Lima Ferreira
Luiz Carlos
LC
Ribeiro-Rodrigues
Rodrigo
R
Talhari
Sinésio
S
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
D019380:Anti-HIV Agents