Petri V, Nishio CE, Nishio PA, Takizawa CM, Michalany NS; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 103 (abstract no. Mo.B.1280).
Federal University of Sao Paulo, Escola Paulista de Medicina-Dept. of Dermatology, Sao Paulo, Brazil. Fax: 55-11-5492127.
Issue: In spite of immunological findings being crucial to understanding important events of HIV disease, leprosy and HIV/AIDS coinfection is not sufficiently focused as a threatening occurence in endemic developing countries. Leprosy may occur in HIV +/AIDS patients with no known contact with leprosy patients, and HIV+ hemophiliacs may be at risk of coinfection in large industrialized cities of endemic countries, with no identification of the source of M. leprae infection. Significance of those events and clinical changes of leprosy in HIV+ were not clear yet. Project: Mitsuda reaction in HIV+ was considered to presume HIV+ people more susceptible to leprosy in endemic countries. In a large urban centre of medium endemicity (Sao Paulo City, Brazil), and with no history of contact with leprosy patients, a white HIV-1+ hemophiliac 32 years of age, having no known contact with leprosy patients, presented cutaneous violaceous lesions mimicking Kaposi's sarcoma (KS). Low probability of KS in hemophiliacs induced histologic examination of the nodule. Close contacts, including his HIV+ wife, were investigated for clinical and immunological signs of leprosy.Results: Skin biopsy of the nodule disclosed typical lepromatous leprosy (as shown in photographs of clinical and histopathological aspects). Low CD4+ lymphocyte counts (less than 100/mm3) corroborated significant impairment of immunocompetence. Source of leprosy infection was not identified among all contacts. Lessons learned: Immunological response to M.leprae is changed in HIV+ people with HIV/AIDS, who may be more susceptible in endemic developing countries. Common clinical signs of lepromatous leprosy may not exist, and it is not known if HIV+ hemophiliacs are more susceptible to lepromatous leprosy than other HIV+ infected people. Transmission by blood and blood products was not fully proven, in spite of the De Las Aguas experience**.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Brazil
- CD4 Lymphocyte Count
- Developing Countries
- HIV Infections
- HIV Seropositivity
- HIV-1
- Humans
- Leprosy
- Leprosy, Lepromatous
- Sarcoma, Kaposi
- Skin
Other ID:
UI: 102217243
From Meeting Abstracts