Department of Dermatology, Tropical Medicine Foundation of Amazonas, Manaus, Amazonas, Brazil.
J Infect Dis. 2010 Aug 15;202(3):345-54. doi: 10.1086/653839.
Although awareness of the relevance of leprosy and human immunodeficiency virus (HIV) coinfection is increasing worldwide, several aspects of this co-occurrence are not fully understood.
We describe clinical, pathological, immunological, and therapeutic long-term follow-up of a cohort of 25 individuals with leprosy and HIV infection from Manaus, Amazonas.
Careful description of our cohort indicates a higher prevalence of leprosy in an HIV-positive population than that in the general population. We also observed upgrading shifting of leprosy clinical forms after initiation of highly active antiretroviral therapy and multidrug therapy and an impact of HIV infection on leprosy granuloma formation, among other features.
Taken together, these new insights allow the proposition of a classification system that includes (1) leprosy and HIV true coinfection, (2) opportunistic leprosy disease, and (3) leprosy related to highly active antiretroviral therapy.
尽管全球范围内对麻风病和人类免疫缺陷病毒（HIV）合并感染相关性的认识不断提高，但这一合并感染的多个方面仍未被充分理解。
我们描述了来自亚马孙州玛瑙斯市的 25 名麻风病合并 HIV 感染患者的临床、病理、免疫和治疗方面的长期随访情况。
对我们的队列进行仔细描述表明，HIV 阳性人群中麻风病的患病率高于普通人群。我们还观察到，在开始高效抗逆转录病毒治疗和多药治疗后，麻风病的临床形式发生了升级转移，以及 HIV 感染对麻风肉芽肿形成等特征的影响。
总之，这些新的见解使得提出一个分类系统成为可能，该系统包括（1）麻风病和 HIV 真正合并感染，（2）机会性麻风病，以及（3）与高效抗逆转录病毒治疗相关的麻风病。
