Peripheral nerve abnormality in HIV leprosy patients.
BACKGROUND:The geographical overlap of HIV (human immunodeficiency virus) and leprosy infection has become increasingly frequent and worrying, bringing many clinical issues. Peripheral neuropathy is very frequent in leprosy because of the predilection of its etiologic agent by Schwann cells of the p...
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ftdoajarticles:oai:doaj.org/article:0fd09a38286549889d151f772def72ac 2023-05-15T15:15:26+02:00 Peripheral nerve abnormality in HIV leprosy patients. Marilia Brasil Xavier Mariana Garcia Borges do Nascimento Keila de Nazare Madureira Batista Danusa Neves Somensi Fernando Octavio Machado Juca Neto Thomaz Xavier Carneiro Claudia Maria Castro Gomes Carlos Eduardo Pereira Corbett 2018-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006633 https://doaj.org/article/0fd09a38286549889d151f772def72ac EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6066254?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006633 https://doaj.org/article/0fd09a38286549889d151f772def72ac PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006633 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006633 2022-12-31T11:42:45Z BACKGROUND:The geographical overlap of HIV (human immunodeficiency virus) and leprosy infection has become increasingly frequent and worrying, bringing many clinical issues. Peripheral neuropathy is very frequent in leprosy because of the predilection of its etiologic agent by Schwann cells of the peripheral nervous system, and it also affects individuals with HIV as one of the most common neurological manifestations. METHODOLOGY/PRINCIPAL FINDINGS:The present study compared a cohort of 63 patients diagnosed with leprosy and coinfected with HIV with a cohort of 64 patients with leprosy alone, who were followed at the outpatient clinic of the Nucleus of Tropical Medicine of the Federal University of Pará, Brazil. We observed that HIV-coinfected leprosy patients presented greater odds of overall peripheral nerve damage (nerve function impairment-NFI) than patients with leprosy alone. More sensitive damage was observed, especially in patients coinfected with multibacillary forms. Leprosy patients coinfected with HIV presented higher chances of motor damage with improvement over time using multidrug therapy (MDT) and highly active antiretroviral therapy (HAART), along with a greater extent of damage and occurrence of neuritis. The data suggest that in addition to patients presenting possible damage caused by leprosy, they also had a greater damage gradient attributable to HIV disease, but not related to HAART because most of these patients had been on the treatment for less than a year. Neuritis was treated with prednisone at doses recommended by the WHO, and coinfected patients had the highest rate of clinical improvement in the first 60 days. CONCLUSIONS/SIGNIFICANCE:The clinical characteristics of the two diseases should be considered in leprosy patients coinfected with HIV for better diagnosis and treatment of peripheral neuropathy. We suggest that new simplified assessment tools that allow the evaluation of the NFI of these patients be developed for use in the service. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 7 e0006633 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Marilia Brasil Xavier Mariana Garcia Borges do Nascimento Keila de Nazare Madureira Batista Danusa Neves Somensi Fernando Octavio Machado Juca Neto Thomaz Xavier Carneiro Claudia Maria Castro Gomes Carlos Eduardo Pereira Corbett Peripheral nerve abnormality in HIV leprosy patients. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:The geographical overlap of HIV (human immunodeficiency virus) and leprosy infection has become increasingly frequent and worrying, bringing many clinical issues. Peripheral neuropathy is very frequent in leprosy because of the predilection of its etiologic agent by Schwann cells of the peripheral nervous system, and it also affects individuals with HIV as one of the most common neurological manifestations. METHODOLOGY/PRINCIPAL FINDINGS:The present study compared a cohort of 63 patients diagnosed with leprosy and coinfected with HIV with a cohort of 64 patients with leprosy alone, who were followed at the outpatient clinic of the Nucleus of Tropical Medicine of the Federal University of Pará, Brazil. We observed that HIV-coinfected leprosy patients presented greater odds of overall peripheral nerve damage (nerve function impairment-NFI) than patients with leprosy alone. More sensitive damage was observed, especially in patients coinfected with multibacillary forms. Leprosy patients coinfected with HIV presented higher chances of motor damage with improvement over time using multidrug therapy (MDT) and highly active antiretroviral therapy (HAART), along with a greater extent of damage and occurrence of neuritis. The data suggest that in addition to patients presenting possible damage caused by leprosy, they also had a greater damage gradient attributable to HIV disease, but not related to HAART because most of these patients had been on the treatment for less than a year. Neuritis was treated with prednisone at doses recommended by the WHO, and coinfected patients had the highest rate of clinical improvement in the first 60 days. CONCLUSIONS/SIGNIFICANCE:The clinical characteristics of the two diseases should be considered in leprosy patients coinfected with HIV for better diagnosis and treatment of peripheral neuropathy. We suggest that new simplified assessment tools that allow the evaluation of the NFI of these patients be developed for use in the service. |
format |
Article in Journal/Newspaper |
author |
Marilia Brasil Xavier Mariana Garcia Borges do Nascimento Keila de Nazare Madureira Batista Danusa Neves Somensi Fernando Octavio Machado Juca Neto Thomaz Xavier Carneiro Claudia Maria Castro Gomes Carlos Eduardo Pereira Corbett |
author_facet |
Marilia Brasil Xavier Mariana Garcia Borges do Nascimento Keila de Nazare Madureira Batista Danusa Neves Somensi Fernando Octavio Machado Juca Neto Thomaz Xavier Carneiro Claudia Maria Castro Gomes Carlos Eduardo Pereira Corbett |
author_sort |
Marilia Brasil Xavier |
title |
Peripheral nerve abnormality in HIV leprosy patients. |
title_short |
Peripheral nerve abnormality in HIV leprosy patients. |
title_full |
Peripheral nerve abnormality in HIV leprosy patients. |
title_fullStr |
Peripheral nerve abnormality in HIV leprosy patients. |
title_full_unstemmed |
Peripheral nerve abnormality in HIV leprosy patients. |
title_sort |
peripheral nerve abnormality in hiv leprosy patients. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006633 https://doaj.org/article/0fd09a38286549889d151f772def72ac |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 7, p e0006633 (2018) |
op_relation |
http://europepmc.org/articles/PMC6066254?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006633 https://doaj.org/article/0fd09a38286549889d151f772def72ac |
op_doi |
https://doi.org/10.1371/journal.pntd.0006633 |
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PLOS Neglected Tropical Diseases |
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12 |
container_issue |
7 |
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e0006633 |
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