PMID- 35245291
OWN - NLM
STAT- MEDLINE
DCOM- 20220422
LR  - 20220422
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Print)
IS  - 1935-2727 (Linking)
VI  - 16
IP  - 3
DP  - 2022 Mar
TI  - Leprosy as immune reconstitution inflammatory syndrome in patients living with 
      HIV: Description of French Guiana's cases over 20 years and systematic review of 
      the literature.
PG  - e0010239
LID - 10.1371/journal.pntd.0010239 [doi]
LID - e0010239
AB  - BACKGROUND: HIV infection is highly prevalent in French Guiana, a territory where 
      leprosy is also endemic. Since the introduction of Highly Active Antiretroviral 
      Treatment (HAART) in the management of HIV, leprosy has been reported as part of 
      the immune reconstitution inflammatory syndrome (IRIS). METHODOLOGY/PRINCIPAL 
      FINDINGS: We aimed to present a general description of these forms of leprosy as 
      IRIS, highlighting clinical and therapeutic specificities. A retrospective study 
      was conducted in French Guiana, including patients living with HIV (PLHIV) with 
      advanced infection (CD4 < 200/mm3) and developing leprosy or a leprosy reaction 
      within six months of HAART initiation, from 2000 to 2020. Clinical, histological 
      and biological data were collected for all these patients. Six patients were 
      reported in French Guiana. A systematic review of the literature was conducted, 
      and its results were added to an overall analysis. Overall, seventy-three PLHIV 
      were included. They were mainly men (74%), aged 22-54 years (median 36 years), 
      mainly from Brazil (46.5%) and India (32.8%). Most leprosy cases (56.2%) were 
      borderline tuberculoid (BT). Leprosy reactions were frequent (74%), mainly type 1 
      reaction (T1R) (68.5%), sometimes intense with ulceration of skin lesions (22%). 
      Neuritis was observed in 30.1% of patients. The outcome was always favorable 
      under multidrug therapy (MDT), continuation of HAART and additional 
      corticosteroid therapy in case of neuritis or ulceration. There was no relapse. 
      CONCLUSION: Leprosy as IRIS in PLHIV mainly presents as a BT leprosy in a T1R 
      state, sometimes with ulcerated skin lesions. Response to MDT is usually good. 
      Systemic corticosteroids are necessary and efficient in case of neuritis.
FAU - Mouchard, Alice
AU  - Mouchard A
AUID- ORCID: 0000-0002-4143-0766
AD  - Service de Dermatologie, Centre hospitalier de Cayenne, Cayenne, French Guiana.
FAU - Blaizot, Romain
AU  - Blaizot R
AUID- ORCID: 0000-0003-3695-6824
AD  - Tropical Biome and Immunophysiopathology (TBIP), Universite de Lille, CNRS, 
      INSERM, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et 
      d'Immunite de Lille, Centre Hospitalier de Cayenne, Universite de Guyane, 
      Cayenne, French Guiana.
FAU - Graille, Jenna
AU  - Graille J
AD  - Service de Dermatologie, Centre hospitalier de Cayenne, Cayenne, French Guiana.
FAU - Couppie, Pierre
AU  - Couppie P
AD  - Service de Dermatologie, Centre hospitalier de Cayenne, Cayenne, French Guiana.
AD  - Tropical Biome and Immunophysiopathology (TBIP), Universite de Lille, CNRS, 
      INSERM, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et 
      d'Immunite de Lille, Centre Hospitalier de Cayenne, Universite de Guyane, 
      Cayenne, French Guiana.
FAU - Bertin, Chloe
AU  - Bertin C
AUID- ORCID: 0000-0003-0062-1184
AD  - Service de Dermatologie, Centre hospitalier de Cayenne, Cayenne, French Guiana.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20220304
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Leprostatic Agents)
SB  - IM
MH  - Anti-Retroviral Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/adverse effects
MH  - Drug Therapy, Combination
MH  - French Guiana/epidemiology
MH  - *HIV Infections/complications/drug therapy/epidemiology
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/epidemiology
MH  - Leprostatic Agents/therapeutic use
MH  - *Leprosy/complications/drug therapy/epidemiology
MH  - Male
MH  - *Neuritis/etiology
MH  - Retrospective Studies
PMC - PMC8947598
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/03/05 06:00
MHDA- 2022/04/23 06:00
PMCR- 2022/03/04
CRDT- 2022/03/04 17:11
PHST- 2021/10/03 00:00 [received]
PHST- 2022/02/08 00:00 [accepted]
PHST- 2022/03/24 00:00 [revised]
PHST- 2022/03/05 06:00 [pubmed]
PHST- 2022/04/23 06:00 [medline]
PHST- 2022/03/04 17:11 [entrez]
PHST- 2022/03/04 00:00 [pmc-release]
AID - PNTD-D-21-01454 [pii]
AID - 10.1371/journal.pntd.0010239 [doi]
PST - epublish
SO  - PLoS Negl Trop Dis. 2022 Mar 4;16(3):e0010239. doi: 10.1371/journal.pntd.0010239. 
      eCollection 2022 Mar.