RESUMEN
Here we report a unique case of tuberculoid leprosy and cytomegalovirus retinitis in a 27-year-old female patient with AIDS, suggestive of highly active antiretroviral therapy (HAART)-induced immune restoration disease. After initiation of HAART, the patient presented with decreased visual acuity, hypoesthetic patch with local nerve thickening, and an increase in her CD4+ T cell count. On further investigations cytomegalovirus retinitis and tuberculoid leprosy were confirmed. To our knowledge no case with such a co-existence has previously been reported.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Terapia Antirretroviral Altamente Activa/efectos adversos , Retinitis por Citomegalovirus/inmunología , Síndrome Inflamatorio de Reconstitución Inmune/inmunología , Lepra Tuberculoide/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/inducido químicamente , Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Infecciones Oportunistas Relacionadas con el SIDA/virología , Síndrome de Inmunodeficiencia Adquirida/microbiología , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Retinitis por Citomegalovirus/inducido químicamente , Retinitis por Citomegalovirus/microbiología , Retinitis por Citomegalovirus/virología , Femenino , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/inducido químicamente , Síndrome Inflamatorio de Reconstitución Inmune/microbiología , Síndrome Inflamatorio de Reconstitución Inmune/virología , Lepra Tuberculoide/inducido químicamente , Lepra Tuberculoide/virologíaRESUMEN
The course of leprosy in patients with HIV infection has been a controversial issue for a long time. It is still a matter of debate whether the HIV status of an individual has any impact on the natural history of leprosy and response to anti-leprosy treatment. We report here three HIV-positive leprosy cases (two BT and one BB) along with their CD4 counts and HIV staging with anti-leprosy therapeutic response. Both BT cases responded well to conventional WHO MDT (PB) for 6 months, whereas the BB case relapsed 3 months after completion of MDT (MB) for one year. However, he became inactive again following a further one-year course of MDT (MB).