02291nas a2200253   4500000000100000008004100001653002400042653001200066653001700078653000800095653002000103100002600123700001500149700001200164700001900176700001800195700001500213700001200228245014900240856005900389300001000448490000700458520157200465       2017                            d10aInfectious Diseases10aleprosy10aCo-infection10aHIV10aCorticosteroids1 aSecchin de Andrade PJ1 aHacker MAV1 aSales A1 aDalvi Garcia F1 aCosta Nery JA1 aMenezes VM1 aSarno E00aTerapia con corticosteroides en pacientes de lepra borderline tuberculoide coinfectados con VIH y con reacción de reversión: estudio clínico   uhttps://www.leprosy-information.org/media/626/download  a21-320 v313 a<p><em>Background: Mycobacterium leprae </em>and HIV cause infectious diseases of great concern for the public health care sector worldwide. Both are especially worrisome diseases when patients become co-infected and exhibit the expected clinical exuberance. The objective of this study was to evaluate episodes of reversal reaction (RR) and the effect of the use of corticosteroids on the treatment of borderline tuberculoid leprosy patients co-infected with the human immunodeficiency virus (HIV).<br />
<em>Methods: </em>This is a retrospective cohort study in which the clinical manifestations of the patients and their responses to corticosteroid therapy were observed. Variables were analysed during and after multidrug therapy between the first and last days of prednisone, which occurred up to a maximum of 6 months after initiating corticosteroid therapy.<br />
<em>Results: </em>A total of 22 HIV-positive and 28 HIV-negative cases were included. Loss of sensitivity and neural thickening were statistically significant while clinically ulcerated lesions were only observed in the co-infected group. Most patients were diagnosed with leprosy in the presence of RR and six patients manifested RR as an immune reconstitution inflammatory syndrome. On average, both groups received similar doses of corticosteroids (difference of 0・1 mg/kg/day).<br />
<em>Conclusions: </em>It is of special interest that the clinical manifestations in both groups were found to be similar and that overall improvement occurred as a result of corticosteroid therapy.</p>