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Journal of Clinical Microbiology, December 2006, p. 4616-4618, Vol. 44, No. 12
0095-1137/06/$08.00+0 doi:10.1128/JCM.01425-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
| CASE REPORT |
Department of Dermatology, Medical School of the University of São Paulo, São Paulo, Brazil,1 Health Institute, São Paulo State Health Department, São Paulo, Brazil,2 Center of Dermatology, São Paulo State Health Department, São Paulo, Brazil,3 Emílio Ribas Infectious Diseases Institute, São Paulo State Health Department, São Paulo, Brazil,4 Lauro de Souza Lima Institute of the São Paulo State Health Department, São Paulo, Brazil,5 Leiden University Medical Centre (LUMC), Leiden, The Netherlands6
Received 10 July 2006/ Returned for modification 31 July 2006/ Accepted 22 September 2006
Two case reports of patients with human immunodeficiency virus type 1 (HIV-1) infection who developed leprosy are presented. Both developed type 1 leprosy reactions in the absence of antiretroviral therapy. Reactions have been described for a number of HIV-1- and Mycobacterium leprae-coinfected patients and have been considered to be part of an immune reconstitution inflammatory syndrome (IRIS) since the reactions were usually linked to the administration of highly active antiretroviral therapy. The reports of our two patients suggest that the type 1 reactions in patients with leprosy and HIV may not always be an IRIS manifestation but may be akin to the classical reactional state described for the natural course of leprosy infection, which occurs in leprosy patients due to the fluctuations of the antimycobacterial immune response, whether they are coinfected with HIV or not.
Published ahead of print on 4 October 2006.
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