[No Title Available]

Rosa, Heitor; Costa, Ana Paula V.F.; Ferraz, Maria Lúcia Gomes; Pedroza, Suelene C.; Andrade, Ana Lúcia; Martelli, Celina Maria Turchi; Zicker, Fábio

doi:10.1590/s0036-46651992000500008

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…The higher prevalence of co‐infection seen in older studies may also be related to the institutionalization of people with leprosy, a practice banned over time. This hypothesis is supported by the fact that patients with a history of institutionalization display a 4‐fold increased risk to be infected with HBV 65 …”

Section: Discussionmentioning

confidence: 93%

“…64 The actual prevalence of chronic HBV-leprosy co-infection has been disputed for many decades, some studies pointing out numbers like the general population, while others present much higher rates ranging from 8 to 60% (Figure 4). 56,[65][66][67][68][69] Historical analysis of prevalence suggests a downward trend over time (Figure 4), probably associated with expansion of vaccination and neonatal prophylaxis for hepatitis B in developing countries in the last decades. The higher prevalence of co-infection seen in older studies may also be related to the institutionalization of people with leprosy, a practice banned over time.…”

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

“…This hypothesis is supported by the fact that patients with a history of institutionalization display a 4-fold increased risk to be infected with HBV. 65 Another important risk related to co-infection is HBV reactivation and disease progression following the use of corticosteroid to treat leprosy reactions. HBV reactivation can occur in patients receiving prednisone ≥20 mg/day (or equivalent) for ≥4 weekswhich is the case of most patients treating reactions.…”

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

“…Several authors recommend that every patient diagnosed with leprosy be tested for hepatitis B and that vaccination be administered to those who do not have detectable antibodies. 56,[65][66][67][68] We endorse this recommendation, as we understand that testing is inexpensive and vaccination of nonimmunized individuals is highly effective.…”

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

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Viral co‐infections in leprosy: a scoping review

et al. 2023

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ContextThe most reported viral co-infections in leprosy are human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV), hepatitis B virus (HBV), hepatitis C virus (HCV), and SARS-CoV-2. In co-infections, the burden of an agent can be increased or decreased by the presence of others. To address this issue, we need to fully understand their prevalence, risk factors, immunology, clinical manifestations, and treatment. The purpose of this scoping review is to describe the clinical and epidemiological characteristics of the most reported viral co-infections in leprosy to inform clinicians and guide future research. MethodsThe authors conducted a literature search of five databases for articles on each of the aforementioned co-infections published prior to October 2022. Two independent reviewers conducted the selection process and identified 53 papers meeting the study inclusion criteria. The data extraction process and evidence synthesis were conducted by one reviewer and double-checked by a second one, consistent with best practice recommendations for scoping reviews.Results For all assessed viruses, most studies reported prevalence rates in leprosy patients higher than the general population. Studies found that HTLV, HBV, and HCV chronic infections were highest in multibacillary leprosy, whereas HIV was mostly found in paucibacillary leprosy, and SARS-Cov-2 affected leprosy subtypes equally. Overall, coinfections were also associated with higher rates of leprosy reactions, except for COVID-19. Forty-six percent of the studies discussed issues related to treatment, which led to favorable outcomes for the most part.Conclusions This review summarizes the existing literature on viral co-infections in leprosy patients, generating valuable insights and recommending areas for future research.

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Section: Discussionmentioning

confidence: 93%

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

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Viral co‐infections in leprosy: a scoping review

et al. 2023

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“…14,15 Varied mechanisms have been proposed to explain the possible role of these triggers in leprosy reactions (Table 6). 14,16–43…”

Section: Discussionmentioning

confidence: 99%

Time to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients

Muddebihal,

Sardana,

Khurana

et al. 2023

Trop Doct

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Existing literature on factors triggering leprosy reactions is based only on case reports and case series, and thus probably gives a biased view. We undertook a case–control study to investigate such purported trigger factors in 42 leprosy reaction patients and 40 non-reactional controls, and the cost of investigations required for the same. Detailed history, clinical evaluation and investigations for triggers were carried out. Infections (typhoid, dental caries) were the most common triggers found, followed by pregnancy. Trigger factors were commoner in the type 2 reaction (T2R) group compared to type 1 (T1R) reaction group. There was however no statistical difference between the two groups. The average estimated cost of investigations was higher in the reactional group and this difference was statistically significant. Hence, except for essential investigations required for initiating steroids, an extensive battery of investigations is unjustified unless the medical history suggests a definitive infective trigger.

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Occult hepatitis B virus infection in patients with leprosy

Costa

Morais

Gonçales

et al. 2018

Journal of Medical Virology

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Leprosy patients may present with immune system impairment and have a higher hepatitis B virus (HBV) seroprevalence, justifying the investigation of occult HBV infection in these individuals. The aim of this study was to verify the frequency and the clinical factors associated with occult HBV infection in leprosy patients. Between 2015 and 2016, leprosy patients from a reference center in Brazil were interviewed to assess clinical data. Blood samples were collected for the screening of HBV serological markers using enzyme‐linked immunosorbent assay. Patients with negative hepatitis B surface antigen (HBsAg) that had positive anti‐HBc and/or anti‐HBs were selected for HBV DNA detection using real‐time polymerase chain reaction. SPSS was used for data analysis. Among 114 selected patients, six were identified with occult infection (5.3%) and five of them with multibacillary leprosy. Three patients with occult infection had a history of a type 2 reaction (P = 0.072; OR, 4.97; 95% CI, 0.87‐28.52). Only two patients with occult infection had isolated anti‐HBc, while three had isolated anti‐HBs, including those with the highest HBV DNA titers. In conclusion, in leprosy patients with negative HBsAg and positive anti‐HBc and/or anti‐HBs, occult HBV infection occurs in 5.3% and can be found even in patients with isolated anti‐HBs.

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[No Title Available]

Cited by 11 publications

References 14 publications

Viral co‐infections in leprosy: a scoping review

Viral co‐infections in leprosy: a scoping review

Time to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients

Occult hepatitis B virus infection in patients with leprosy

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