@article{33629,
  author = {Fairley J and Ferreira JA and Grossi de Oliveira AL and Filippis T and Faria Grossi MA and Chaves LP and Caldeira LN and Souza Dos Santos P and Costa RR and Diniz MC and Duarte CS and Pôrto LAB and Suchdev PS and Negrão-Corrêa DA and Carmo Magalhães F and Peixoto Moreira JM and Melo Freire Júnior A and Cerqueira MC and Kitron U and Lyon S},
  title = {The burden of helminth coinfections and micronutrient deficiencies in patients with and without leprosy reactions: A pilot study in Minas Gerais, Brazil.},
  abstract = {<p>Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case-control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against , , and antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.</p>
},
  year = {2019},
  journal = {The American journal of tropical medicine and hygiene},
  issn = {1476-1645},
  doi = {10.4269/ajtmh.18-0502},
  language = {eng},
}