Human Immunodeficiency Virus and Leprosy Coinfection in Pune, India

Abstract

We report eight cases and the incidence of leprosy in human immunodeficiency virus (HIV)-infected individuals after initiation of antiretroviral treatment (ART). The incidence of leprosy in patients on ART was 5.22 per 1,000 person-years (95% confidence interval, 2.25 to 10.28). This high incidence suggests that there should be regular examination of HIV-infected individuals for clinical signs of leprosy.

Type 2 lepra reaction in an immunocompromised patient precipitated by filariasis

“…[12] Vinay et al ., reported a case series of eight patients in which three had type 2 lepra reaction. [6] Similarly Pai et al ., reported a case series of 11 patients coinfected with HIV and leprosy in which two patients had type 2 lepra reaction. [7] In our review of literature on the concerned topic, we found two more case reports of patients with HIV and leprosy coinfection.…”

“…In a study by Vinay et al ., the incidence of leprosy in patients on ART was 5.22 per 1,000 person-years (95% confidence interval, 2.25-10.28). [6] Patients affected with both AIDS and leprosy commonly present with type 1 lepra reaction, usually on initiation of ART as a type of immune reconstitution disease (IRD). [34] Rarely such patients when affected with lepromatous or borderline lepromatous leprosy can present with type 2 lepra reaction.…”

Hansen’s disease and HIV coinfection with facial nerve palsy

“…There is a declining trend in the global burden of leprosy, but still there are 15 countries in Asia and Africa including India that account for 94% of the newly detected cases globally. [ 1 ] Both human immunodeficiency virus (HIV) and leprosy are associated with social stigma. Leprosy can manifest as immune reconstitution inflammatory syndrome (IRIS) in HIV-infected individuals.…”

Reversal Reaction as a Manifestation of Immune Reconstitution Inflammatory Syndrome

“…One study, in French Guyana, has observed that the incidence of leprosy was higher in HIV patients receiving HAART for less than 3 months than in HIV untreated patients (13 against 0,7 per 1,000 person-year, p=0,02) (Couppié et al, 2009). Another study, in India, has found a high incidence of leprosy of 5.22 per 1,000 person-year in HIV patients on HAART (Vinay et al, 2009). Several case reports of leprosy associated with IRIS have been published in the literature (Martiniuk et al, 2007;Chow et al, 2009), including one of histoid leprosy case (Bumb et al, 2010).…”

“…The mean time that patients developed reaction after initiation of HAART was 18.95 (4-172) weeks (median:8, Mode:8, standard deviation:31,1) (Tables 1 and 2). Twenty three (56.09%) of the cases were from Brazil (Pereira et al, 2004;Visco-Comandini et al, 2004;Trindade et al, 2005;Talhari et al, 2007;Caruso et al, 2007;Batista et al, 2008;Deps et al, 2008& Menezes et al, 2009, 13 (31.7%) from India (Narang et al, 2005;Singal et al, 2006;Kharkar et al, 2007;Kar et al, 2009&Vinay et al, 2009, 3 (7.31%) from Haiti (Couppié et al, 2004& Pavie et al, 2009), 1 (2.43%) from Uganda (Lawn et al, 2003) and 1(2.43%) from French Guiana (Couppié et al, 2004). Thirty one (75.6%) patients were man and 10 (27.3%) women.…”