02696nas a2200325   4500000000100000008004100001100001400042700001600056700002600072700001500098700002000113700001400133700001600147700002300163700001300186700001300199700001400212700001500226700001500241700002300256700002300279700002300302700002600325700001700351700001300368700001100381245015800392520180600550022001402356       2019                            d1 aFairley J1 aFerreira JA1 aGrossi de Oliveira AL1 aFilippis T1 aFaria Grossi MA1 aChaves LP1 aCaldeira LN1 aSouza Dos Santos P1 aCosta RR1 aDiniz MC1 aDuarte CS1 aPôrto LAB1 aSuchdev PS1 aNegrão-Corrêa DA1 aCarmo Magalhães F1 aPeixoto Moreira JM1 aMelo Freire Júnior A1 aCerqueira MC1 aKitron U1 aLyon S00aThe burden of helminth coinfections and micronutrient deficiencies in patients with and without leprosy reactions: A pilot study in Minas Gerais, Brazil.3 a<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>
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