02820nas a2200421   4500000000100000008004100001260001300042653001500055653001000070653002100080653000900101653002200110653001100132653001000143653002100153653001600174653002600190653001100216653001100227653001200238653000900250653001600259653002100275653001600296100001300312700001500325700001800340700001400358700001300372700001100385245006300396856007900459300001100538490000700549050001500556520181300571022001402384       2012                            d  c2012 Oct10aAdolescent10aAdult10aAge Distribution10aAged10aAged, 80 and over10aBrazil10aChild10aChild, Preschool10aCoinfection10aEpidemiologic Methods10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10aSex Distribution10aYoung Adult1 aMotta AC1 aPereira KJ1 aTarquínio DC1 aVieira MB1 aMiyake K1 aFoss N00aLeprosy reactions: coinfections as a possible risk factor.  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460016/pdf/cln-67-10-1145.pdf  a1145-80 v67  aMOTTA 20123 a<p><b>OBJECTIVE: </b>This study aimed to determine the frequency of coinfections in leprosy patients and whether there is a relationship between the presence of coinfections and the development of leprosy reactional episodes.</p><p><b>METHOD: </b>A cross-sectional study based on an analysis of the medical records of the patients who were treated at the Leprosy Clinics of the Ribeirão Preto Medical School, University of São Paulo, was conducted from 2000 to 2010. Information was recorded regarding the age, sex, clinical status, WHO classification, treatment, presence of reactions and coinfections. Focal and systemic infections were diagnosed based on the history, physical examination, and laboratory tests. Multinomial logistic regression was used to evaluate the associations between the leprosy reactions and the patients' gender, age, WHO classification and coinfections.</p><p><b>RESULTS: </b>Two hundred twenty-five patients were studied. Most of these patients were males (155/225 = 68.8%) of an average age of 49.31±15.92 years, and the most prevalent clinical manifestation was the multibacillary (MB) form (n = 146), followed by the paucibacillary (PB) form (n = 79). Erythema nodosum leprosum (ENL) was more prevalent (78/122 = 63.9%) than the reversal reaction (RR) (44/122 = 36.1%), especially in the MB patients (OR 5.07; CI 2.86-8.99; p<0.0001) who exhibited coinfections (OR 2.26; CI 1.56-3.27; p<0.0001). Eighty-eight (88/225 = 39.1%) patients exhibited coinfections. Oral coinfections were the most prevalent (40/88 = 45.5%), followed by urinary tract infections (17/88 = 19.3%), sinusopathy (6/88 = 6.8%), hepatitis C (6/88 = 6.8%), and hepatitis B (6/88 = 6.8%).</p><p><b>CONCLUSIONS: </b>Coinfections may be involved in the development and maintenance of leprosy reactions.</p>  a1980-5322