02663nas a2200241   4500000000100000008004100001653001300042653001200055653002300067653001500090100001500105700001600120700001400136700001500150700002100165700001100186245009900197856007300296300000900369490000700378520202200385022001402407       2016                            d10aSerology10aleprosy10aHousehold contacts10aAntibodies1 aWambier CG1 aWambier SPF1 aFurini RB1 aSimão JCL1 aCipriani Frade M1 aFoss N00aFactors associated with seropositivity for APGL-Iamong household contacts of leprosy patients.  uhttp://www.scielo.br/pdf/rsbmt/v49n1/1678-9849-rsbmt-49-01-00083.pdf  a83-90 v493 a<p><strong>INTRODUCTION: </strong>Leprosy is mainly transmitted among family members who share genetic and ambient factors. The clinical form of leprosy in the index case and kinship could be risk factors for leprosy transmission. High antibody levels in household contacts (HC) in the absence of neural or skin lesions may characterize latent infection. This study aimed to evaluate the association between seropositivity for anti-phenolic glycolipid-I immunoglobulin M antibodies (APGL-I) in HC and the clinical classification of the index case and to analyze the association between APGL-I positivity with other factors such as age, kinship, and gender.</p>

<p><strong>METHODS: </strong>We performed a survey among 320 HC of 120 leprosy patients who were evaluated and followed-up in a leprosy outpatient clinic of a university hospital. All HC underwent complete skin examination, peripheral nerve palpation, skin sensory tests, and serologic tests for the detection and quantification of APGL-I.</p>

<p><strong>RESULTS: </strong>The overall seropositivity rate was 20%, and was greatly affected by kinship. APGL-I seropositivity was higher in siblings (41%), followed by parents (28%), spouses (26%), other (19%), and offspring (14%). Independent risk factors for seropositivity were being siblings (OR 3.3) and being a HC of an index case with indeterminate leprosy (OR 5.3). APGL-I seropositivity was associated with index cases with a bacillary index of 4 (88%; p&lt;.001). Seropositivity among HC was not significantly associated with their gender and age. There was no statistical difference in the seropositivity rates of HC of index patients with paucibacillary and multibacillary leprosy.</p>

<p><strong>CONCLUSIONS: </strong>Strict evaluation and follow-up of HC with positive results for APGL-I is recommended. Special attention should be paid during the screening of siblings of the index cases, HC of patients with a high bacillary index, and HC of patients with indeterminate leprosy.</p>
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