Brazil is one of the few countries remaining endemic for infection for human
immunodeficiency virus (HIV) and leprosy, and these diseases have a major impact
on social costs and on quality of life. Although it is recognized the importance of this
co-infection, various aspects are not fully understood yet. This study aims to describe
the clinical, histopathological and immunopathological aspects of reactional states of
patients coinfected HIV/leprosy, comparing them to leprosy patients without HIV.
Were followed two groups: (1) 40 patients coinfected with HIV/leprosy, (2) consists of
107 leprosy patients. Prevailed male subjects in both groups. In Group 1, the majority
were paucibacillary (70%), as borderline tuberculoid (45%) and with less risk of
having lepra reaction in relation to non-coinfected. All of coinfected who had lepra
reaction (n = 15) were taking antiretroviral therapy (ART), and most in the aids status
(n = 14), being Immune Reconstitution Syndrome (IRS) a clinical condition markedly
important in many of these patients (n=7). In the group of non-coinfected, the pattern
of infection was the majority multibacillary (80.4%), type borderline-borderline
(40.2%), and higher relative risk of presenting lepra reactions (p = 0.0026). The
reversal reaction was the most common in both groups. In the coinfected group were
observed skin lesions with aspect according to expected for each clinical form, in
general, erythematous infiltrated with similar evolution to non-coinfected. The dermal
edema was the most common histopathological findings in both groups. In group 1,
giant cells were found in all histopathological and in greater quantity (2 +) and large
size. The morphology of erythema nodosum leprosum no presented significant
differences between groups, as well as the expression of IL-1 and IL-6. This study
confirms the hypothesis that clinical and immunopathological aspects of reactions in
these patients is an inflammatory active status, not of anergy, similar to that found in
non-coinfected.
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