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Anais Brasileiros de Dermatologia
On-line version ISSN 1806-4841
CARUSO, Rafaela de Lima et al. Atypical reversal reaction in a borderline leprosy patient co-infected with HIV. An. Bras. Dermatol. [online]. 2007, vol.82, n.6, pp.553-557. ISSN 1806-4841. http://dx.doi.org/10.1590/S0365-05962007000600009.
HIV infection does not modify the natural course of leprosy. However, HIV co-infection seems to be associated with an increased rate of reactional states and more severe cases of neuritis. The authors describe a case of borderline tuberculoid leprosy in a HIV-positive patient who developed a marked reversal reaction. Atypical and rare skin manifestations, such as verrucous lesions and ulcers, appeared after highly active antiretroviral therapy, which resulted in increased CD4+ T-lymphocyte count and drop in viral load. The restoration of the cellular immunity in HIV-seropositive patients can trigger reversal reactions that are one of the manifestations of the immune reconstitution inflammatory syndrome. Only recently the syndrome has been associated with leprosy.
Keywords : Antiretroviral therapy; highly active; HIV; Immunity, cellular; Leprosy, borderline.