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An In Vitro Model for Measuring Immune Responses to Malaria in the Context of HIV Co-infection
Published on: October 6, 2015
Interactions between HIV infection and leprosy: a paradox
Andrew P Ustianowski1, Stephen D Lawn, Diana N J Lockwood
1The Hospital for Tropical Diseases, London, UK.
The Lancet. Infectious Diseases
|May 27, 2006
Summary
Concerns about HIV undermining leprosy control have not materialized. HIV and Mycobacterium leprae coinfection show subtle interactions, with preserved cell-mediated immunity at the disease site, unlike tuberculosis.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Early HIV epidemic fears suggested it would disrupt leprosy control, similar to tuberculosis.
- Predictions included increased lepromatous disease, faster evolution, and treatment difficulty in HIV-leprosy coinfection.
Purpose of the Study:
- To review epidemiological, clinical, and pathological data on leprosy/HIV coinfection.
- To understand the interaction between HIV and Mycobacterium leprae.
Main Methods:
- Review of published epidemiological data on HIV prevalence in leprosy cases.
- Analysis of clinical spectrum and immune responses in coinfected patients.
- Histopathological examination of leprosy lesions in coinfected individuals.
Main Results:
- Epidemiological data show no increased HIV prevalence or altered leprosy spectrum.
- Immune-mediated reactions in leprosy may occur more frequently in coinfected patients.
- Leprosy can present as immune reconstitution disease in patients on antiretroviral therapy.
- Histopathology reveals preserved cell-mediated immunity to M. leprae at the lesion site, despite systemic immune compromise.
Conclusions:
- HIV/Mycobacterium leprae interaction is more subtle than HIV/tuberculosis.
- Cell-mediated immunity to M. leprae appears preserved at the disease site, a key difference from tuberculosis.
- Further research into leprosy/HIV coinfection is warranted.
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