Mycobacterium leprae DNA associated with type 1 reactions in single lesion paucibacillary leprosy treated with single dose rifampin, ofloxacin, and minocycline.
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| Abstract |
Leprosy affects skin and peripheral nerves, and acute inflammatory type 1 reactions (reversal reaction) can cause neurologic impairment and disabilities. Single skin lesion paucibacillary leprosy volunteers (N = 135) recruited in three Brazilian endemic regions, treated with single-dose rifampin, ofloxacin, and minocycline (ROM), were monitored for 3 years. Poor outcome was defined as type 1 reactions with or without neuritis. IgM anti-phenolic glycolipid I, histopathology, Mitsuda test, and Mycobacterium leprae DNA polymerase chain reaction (ML-PCR) were performed at baseline. chi(2) test, Kaplan-Meir curves, and Cox proportional hazards were applied. The majority of volunteers were adults with a mean age of 30.5 +/- 15.4 years; 44.4% were ML-PCR positive. During follow-up, 14.8% of the patients had a poor clinical outcome, classified as a type 1 reaction. Older age (> or = 40 years), ML-PCR positivity, and lesion size > 5 cm were associated with increased risk. In multivariate analysis, age (> or = 40 years) and ML-PCR positivity remained baseline predictors of type 1 reaction among monolesion leprosy patients.
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| Authors | Ana Lucia O M Sousa, Mariane M A Stefani, Gisner A S Pereira, Mauricio B Costa, Paula F Rebello, Maria Katia Gomes, Kazue Narahashi, Thomas P Gillis, James L Krahenbuhl, Celina M T Martelli |
| Journal | The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 77 Issue 5 Pg. 829-33 (Nov 2007) ISSN: 1476-1645 [Electronic] United States |
| PMID | 17984336 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't) |
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