Association between NDO-LID and PGL-1 for leprosy and class I and II human leukocyte antigen alleles in an indigenous community in Southwest Amazon

Teles, Stéfanie Ferreira; Silva, Eliane Aparecida; Souza, Rodrigo Medeiros de; Tomimori, Jane; Florian, Marcos César; Marcos, Elaine Valim Camarinha; Souza-Santana, Fabiana Covolo de; Gamba, Mônica Antar

doi:10.1016/j.bjid.2020.05.009

Cited by 4 publications

(1 citation statement)

References 40 publications

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“…The innate response to leprosy might be affected by specific alleles of immune genes, notably PARK2 / PACRG ( 17 , 18 ). Likewise, the cellular response to this disease could be influenced by a certain number of HLA genes observed in native Americans ( 19 , 20 ). As Amerindians of French Guiana should be expected to share common genetic features with their Brazilian cousins, this contrasting incidence of leprosy should be explained by better access to healthcare.…”

Section: Discussionmentioning

confidence: 99%

Leprosy in French Guiana, 2015 to 2021: Dynamics of a Persistent Public Health Problem

et al. 2023

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A resurgence of leprosy as a public health problem in French Guiana was reported over the period 2007 to 2014, particularly among Brazilians gold miners. Prolonged multidrug therapy and reversal reactions represent a therapeutic challenge. The objective of this study was to assess the evolution of leprosy in this European overseas territory. All patients with leprosy confirmed in histopathology between 1 January 2015 and 31 December 2021 were included. A total of 86 patients were included, including 64 new cases and 22 previously diagnosed cases. Sixty patients (70%) were male, 6 cases were paediatric. Brazilian gold miners represented 44.1% of reported occupations (15/34). Maroons represented the second community (13 patients, 15%). Multibacillary and paucibacillary forms were found in 53 (71%) and 22 (29%) patients, respectively. The annual prevalence never exceeded the threshold of 1/10,000. The mean incidence and prevalence were significantly lower than during the period 2007 to 2014 (p < 0.0001). Reversal reactions were found in 29 patients and almost always required a long course of steroids. Infliximab allowed a reduction in the length of treatment with steroids in 2/2 cases. In conclusion, the prevalence of leprosy has decreased significantly in French Guiana, but remains driven by the population of illegal gold miners. Anti-tumour necrosis factor (anti-TNF) drugs represent a promising option in the management of reversal reactions.

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