Immune Reconstitution Inflammatory Syndrome Associated With HIV and Leprosy

Couppié, Pierre; Abel, Sylvie; Voinchet, H.; Roussel, M.; Helenon, R.; Huerre, Michel; Sainte‐Marie, D.; Cabie, André

doi:10.1001/archderm.140.8.997

Cited by 91 publications

(54 citation statements)

References 13 publications

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“…5,8,9 Apesar da infecção pelo vírus HIV ter baixo impacto no desenvolvimento e evolução da Hanseníase, essa micobacteriose, bem como os quadros reacionais associados a ela, podem se apresentar, como manifestação de síndrome de reconstituição imune. 2,3 Não existem critérios bem estabelecidos para o diagnóstico de reação hansênica, entretanto um estudo realizado em Recife, no estado de Pernambuco, avaliando 201 pacientes com história de quadro reacional, considerou para o diagnóstico de reação reversa pelo menos uma das seguintes manifestações clínicas:…”

Section: Discussionunclassified

Reação hansênica reversa associada à síndrome de reconstituição imune

et al. 2017

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RESUMOHanseníase é uma doença causada pelo Mycobacterium leprae que afeta principalmente pele e nervos. Em muitos países subdesenvolvidos, a prevalência de HIV e Hanseníase tem aumentado, consequentemente o número de pessoas coinfectadas também. Relata-se o caso de uma paciente coinfectada por essas duas doenças apresentando quadro de úlceras profundas e muito dolorosas em antebraço direito 3 meses após a introdução de terapia antirretroviral. Após investigação para descartar outras causas de lesões cutâneas ulcerativas, a paciente obteve diagnóstico de reação reversa atípica fazendo parte de um quadro de síndrome de reconstituição imune. A paciente recebeu tratamento com prednisona e obteve resolução do quadro. Apesar da infecção pelo vírus HIV ter baixo impacto no desenvolvimento e evolução da Hanseníase, essa micobacteriose, bem como os quadros reacionais associados a ela, podem se apresentar como manifestação de síndrome de reconstituição imune. Palavras-chave: ABSTRACTLeprosy is a disease caused by Mycobacterium leprae that affects mainly skin and nerves. In many developing countries, the prevalence of HIV and Leprosy has increased and consequently the number of people with coinfection as well. Here we report the case of a patient coinfected by these two infectious diseases who presented deep painful ulcers in the right forearm three months after the start of antiretroviral therapy. After assessment to rule out other causes for the cutaneous ulcerative lesions, it with prednisone and achieved remission of the symptoms. However infection with HIV is reported to have low impact on the development and evolution of Leprosy, this mycobacteriosis, as well as the reactions patterns associated with it, can be presented Keywords:Autor correspondente:

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Section: Discussionunclassified

Reação hansênica reversa associada à síndrome de reconstituição imune

et al. 2017

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15] Since its first report in 2003, it has become clear that the introduction of HAART changed the natural history of leprosy in HIV-infected patients. 3,15 In 19 cases (including the patient we describe) the clinical manifestations of IRIS were leprosy type-1 reactions, some unusually severe and associated with vasculitis and ulcerous progression.…”

Section: Discussionmentioning

confidence: 99%

Leprosy and Kaposi sarcoma presenting as an immune reconstitution inflammatory syndrome in a patient with AIDS

Medeiros

Coelho

Fernandes

et al. 2009

Journal of the American Academy of Dermatology

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“…2 IRIS merupakan perubahan status klinis yang paradoks setelah memulai HAART pertama kali saat angka CD4+ sangat rendah, umumnya kurang dari 200/ uL 18 . Hal ini terkait dengan respons imun seseorang yang kembali atau reaktivasi terhadap proses penyakit subklinis atau laten.…”

Section: Pengaruh Anti Retroviral Therapy (Art) Terhadap Ko-infeksi Lunclassified

“…Penyakit inflamasi muncul 1 hingga 6 bulan setelah terapi efektif dimulai, selama periode transisi replikasi virus dihambat, angka limfosit CD4+ meningkat, dan terjadi perbaikan respons imun. 18 Rejimen HAART saat ini digunakan untuk meningkatkan produksi dan redistribusi sel CD4+ dan memperbaiki imunitas spesifik terhadap patogen, HIV dan patogen lain. 3 Tahun 2003, 23 kasus pasien lepra dengan IRIS telah dipublikasikan, terutama pada negaranegaradengan ketersediaan ART, 70% kasus dari Amerika Selatan dan 20% dari India.…”

Section: Pengaruh Anti Retroviral Therapy (Art) Terhadap Ko-infeksi Lunclassified

“…15 HAART akan memicu manifestasi klinis koinfeksi dengan tuberkulosis, limfadenitis, sitomegalovirus, herpes zoster, hepatitis B dan C virus, dan lepra. 18 Kasus lepra dapat dihubungkan dengan IRIS apabila memenuhi persyaratan sebagai berikut 2 : 1) lepra atau reaksi lepra terjadi dalam 6 bulan HAART dimulai; 2) infeksi HIV lanjut; 3) CD4+ rendah dihitung sebelum memulai HAART; 4) CD4+ meningkat setelah pemberian HAART .…”

Section: Pengaruh Anti Retroviral Therapy (Art) Terhadap Ko-infeksi Lunclassified

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Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

Anggraini¹

2017

JIK

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Human immunodefficiency virus (HIV) epidemic covers several countries with endemic leprosy without any significantincrease in the number of patients co-infected with HIV and leprosy, so it can be concluded that HIV-positive does notincrease the risk of developing leprosy. Clinicopathological spectrum of leprosy patients who are co-infected withHIV is not changed. Leprosy may be attributed to the presence of immune recovery syndrome after the administrationof highly active antiretroviral therapy (HAART). Long-term incubation period and the low incidence of leprosy inpatients with HIV make prospective cohort or case-control studies on the prevalence of leprosy among a group of HIVpositive and HIV negative hardly possible to be performed. The benefit of this circumstance is the HIV pandemicdoes not become a nuisance of the effort to control leprosy. Further studies on the molecular pathogenesis of M.leprae and other mycobacterial can provide an understanding of the differences of the pathogenesis in patients withHIV infection.

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Immune Reconstitution Inflammatory Syndrome Associated With HIV and Leprosy

Cited by 91 publications

References 13 publications

Reação hansênica reversa associada à síndrome de reconstituição imune

Reação hansênica reversa associada à síndrome de reconstituição imune

Leprosy and Kaposi sarcoma presenting as an immune reconstitution inflammatory syndrome in a patient with AIDS

Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

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