Leprosy pp 341-346 | Cite as

Leprosy and HIV/AIDS Co-infection



Contrary to early expectations, it seems that there is no significant increase in global leprosy and HIV co-occurrence. However, most of the larger studies on the subject were done in the early to mid 1990s, in African countries, following designs with limited power to describe the true impact of co-infection. Moreover, the introduction of highly active antiretroviral therapy (HAART) altered the clinical evolution of HIV infection, consequently leading to increasing reports of immune reconstitution inflammatory syndrome (IRIS) associated with leprosy. Although it has been argued that this association may have no impact on public health, its true importance remains to be elucidated. Finally, leprosy manifests in a wide range of clinical presentations, which sometimes imposes a clinical challenge and may lead to misdiagnosis.


Immune Reconstitution Inflammatory Syndrome Mycobacterium Avium Mycobacterium Avium Complex Lepromatous Leprosy Mycobacterium Avium Complex Infection 


  1. 1.
    World Health Organization (2009) Global leprosy situation, 2009. Wkly Epidemiol Rec 84:333–340Google Scholar
  2. 2.
    UNAIDS/WHO (2009) Aids epidemic update. December 2009. http://data.unaids.org:80/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf. Accessed 3 June 2010
  3. 3.
    Ustianowski AP, Lawn SD, Lockwood DNJ (2006) Interactions between HIV infection and leprosy: a paradox. Lancet Infect Dis 6:350–360PubMedCrossRefGoogle Scholar
  4. 4.
    Talhari C, Mira MT, Massone C et al (2010) Leprosy and HIV coinfection: a clinical, pathological, immunological, and therapeutic study of a cohort from a Brazilian referral center for infectious diseases. J Infect Dis 202(3):345–354PubMedCrossRefGoogle Scholar
  5. 5.
    Huiras E, Preda V, Maurer T et al (2008) Cutaneous manifestations of immune reconstitution inflammatory syndrome. Curr Opin HIV AIDS 3:453–460PubMedCrossRefGoogle Scholar
  6. 6.
    Deps PD, Lockwood DN (2008) Leprosy occurring as immune reconstitution syndrome. Trans R Soc Trop Med Hyg 102:966–968PubMedCrossRefGoogle Scholar
  7. 7.
    Talhari C, Machado PR, Ferreira LC et al (2007) Shifting of the clinical spectrum of leprosy in an HIV-positive patient: a manifestation of immune reconstitution inflammatory syndrome? Lepr Rev 78:151–154PubMedGoogle Scholar
  8. 8.
    Talhari C, Ferreira LC, Araújo JR et al (2008) Immune reconstitution inflammatory syndrome or upgrading type 1 reaction? Report of two AIDS patients presenting a shifting from borderline lepromatous leprosy to borderline tuberculoid leprosy. Lepr Rev 79:429–435PubMedGoogle Scholar
  9. 9.
    Sampaio EP, Caneshi JR, Nery JA et al (1995) Cellular immune response to Mycobacterium leprae infection in human immunodeficiency virus-infected individuals. Infect Immun 63:1848–1854PubMedGoogle Scholar
  10. 10.
    Pereira GA, Stefani MM, Araújo Filho JA et al (2004) Human immunodeficiency virus type 1 (HIV-1) and Mycobacterium leprae co-infection: HIV-1 subtypes and clinical, immunologic, and histopathologic profiles in a Brazilian cohort. Am J Trop Med Hyg 71:679–684PubMedGoogle Scholar
  11. 11.
    Massone C, Talhari C, Ribeiro-Rodrigues R et al (2011) Leprosy and HIV coinfection: a critical approach. Expert Rev Anti Infect Ther 9:701–710Google Scholar
  12. 12.
    Massone C, Talhari C, Talhari S et al (2012) Immunophenotype of skin lymphocytic infiltrate in patients co-infected with Mycobacterium leprae and human immunodeficiency virus: a scenario dependent on CD8+ and/or CD20+ cells. Br J Dermatol (in press)Google Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  1. 1.Department of Dermatology, Faculty of MedicineNilton Lins UniversityManausBrazil

Personalised recommendations