title: Leprosy and HIV coinfection: a critical approach.
abstract: An increase in leprosy among HIV patients, similar to that observed in patients with TB, was expected approximately 20 years ago. Studies conducted in the 1990s together with those reported recently seemed to indicate that a coinfection with HIV did not alter the incidence and the clinical spectrum of leprosy and that each disease progressed as a single infection. By contrast, in countries with a high seroprevalence of HIV, TB was noted to increase. Explanations may be provided by the differences in the incubation time, the biology and toxicity of Mycobacterium leprae and Mycobacterium tuberculosis. After the introduction of HAART the leprosy-HIV coinfection manifested itself as an immune reconstitution inflammatory syndrome (IRIS), typically as paucibacillary leprosy with type 1 leprosy reaction. The incidence of leprosy in HIV-infected patients has never been properly investigated. IRIS-leprosy is probably underestimated and recent data showed that the incidence of leprosy in HIV patients under HAART was higher than previously thought.
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria. cesare.massone@klinikum-graz.at
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: Carolina
authors.initials: C
authors.lastname: Talhari
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ribeiro-Rodrigues
authors.forename: Renata Helena Monteiro
authors.initials: RH
authors.lastname: Sindeaux
authors.forename: Marcelo Távora
authors.initials: MT
authors.lastname: Mira
authors.forename: Sinesio
authors.initials: S
authors.lastname: Talhari
authors.forename: Bernard
authors.initials: B
authors.lastname: Naafs
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D000998:Antiviral Agents / Q000627:therapeutic use; D015897:Comorbidity; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000473:pathology / Q000821:virology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D015994:Incidence; D007918:Leprosy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D009166:Mycobacterium leprae / Q000502:physiology; D009169:Mycobacterium tuberculosis / Q000502:physiology; D013045:Species Specificity; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents