02096nas a2200301   4500000000100000008004100001260001200042653001200054653001900066653001900085653002200104653000900126653001200135100001500147700001500162700001500177700001100192700001300203700001300216700001400229700001700243700001300260700001300273700001400286245009900300520138100399022001401780       2024                            d  c11/202410aleprosy10aanti‐PGL‐I10aHistopathology10aMultidrug therapy10aqPCR10aRelapse1 aDornelas B1 ada Costa W1 ade Abreu J1 aDaud J1 aCampos F1 aCampos D1 aAntunes D1 ade Araújo L1 aSantos D1 aSoares C1 aGoulart I00aImpact of histopathological and serological assessments on early diagnosis of leprosy relapse.3 a<p>This study aimed to identify laboratory factors predicting leprosy relapse (LR) after multi-drug therapy (MDT). A case-control study included 80 patients treated with MDT at a national reference center over 12 years. The Relapse Group had 40 patients who relapsed after an average of 89.2 months post-MDT, while the Control Group had 40 patients who remained asymptomatic for an average of 113.1 months. Significant predictors of LR included neural/perineural lymphocytic infiltrate (OR = 4.67; p = 0.0076) and foamy granulomas (OR = 15.55; p = 0.0005), increasing odds by 4.7 and 15.6 times, respectively. The Relapse Group had a mean histological bacillary index (hBI) of 3.23+ compared to 1.8 in the Control Group (p = 0.004). An hBI ≥3+ had 72% sensitivity and 65% specificity for detecting LR (AUC = 0.72; p = 0.0002). Elevated anti-phenolic glycolipid I (anti-PGL-I) IgM antibody levels (ELISA index, EI ≥1) were also associated with LR (OR = 4.67; p = 0.0031). An EI ≥3.6 had 71% sensitivity and 62% specificity (AUC = 0.70; p = 0.0012). Multivariate analysis indicated that neural/perineural infiltrate, foamy granulomas, hBI ≥ 1+, and EI ≥ 1 significantly predicted LR, with up to 94.32% probability. Conclusively, these factors can identify individuals at high probability of LR after MDT.</p>
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