Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts.

AbstractBACKGROUND:Household contacts constitute the highest risk group for leprosy development, and despite significant progress in the disease control, early diagnosis remains the primary goals for leprosy management programs.METHODS:We have recruited 175 seropositive and 35 seronegative household contacts from 2014 to 2016, who were subjected to an extensive protocol that included clinical, molecular (peripheral blood qPCR, slit-skin smear qPCR, skin biopsy qPCR) and electroneuromyographic evaluations.RESULTS/PRINCIPAL FINDINGS:The positivity of peripheral blood qPCR of seropositive contacts was 40.6% (71/175) whereas only 8.6% (3/35) were qPCR positive in seronegative contacts (p = 0.0003). For the slit-skin smear, only 4% (7/175) of seropositive contacts presented positive bacilloscopy, whereas the qPCR detected 47.4% (83/175) positivity in this group compared with only 17.1% (6/35) in seronegative contacts (p = 0.0009). In the ENMG evaluation of contacts, 31.4% (55/175) of seropositives presented some neural impairment, and 13.3% (4/35) in seronegatives (p = 0.0163). The presence of neural thickening conferred a 2.94-fold higher chance of ENMG abnormality (p = 0.0031). Seropositive contacts presented a 4.04-fold higher chance of neural impairment (p = 0.0206). The peripheral blood qPCR positivity presented odds 2.08-fold higher towards neural impairment (OR, 2.08; p = 0.028). Contrarily, the presence of at least one BCG vaccine scar demonstrated 2.44-fold greater protection against neural impairment (OR = 0.41; p = 0.044).CONCLUSIONS/SIGNIFICANCE:ELISA anti-PGL-I is the most important test in determining the increased chance of neural impairment in asymptomatic leprosy household contacts. The combination of the two assays (ELISA anti-PGL-I and peripheral blood qPCR) and the presence of BCG scar may identify individuals with higher chances of developing leprosy neuropathy, corroborating with the early diagnosis and treatment.

Molecular Evidence for the Aerial Route of Infection of Mycobacterium leprae and the Role of Asymptomatic Carriers in the Persistence of Leprosy.

 O Centro de Referência Nacional em Dermatologia Sanitária e Hanseníase da Universidade Federal de Uberlândia MG, Brasil (CREDESH/ UFU-MG) tem experiência na aplicação da reação em cadeia da polimerase em tempo real (qPCR) para detecção de DNA de M. leprae e da sorologia ELISA

Diagnosis of mycobacterial infections based on acid-fast bacilli test and bacterial growth time and implications on treatment and disease outcome.

Background: The establishment of therapeutic regimens for mycobacteriosis depends on the accurate identificationof Mycobacterium species, and misdiagnosis can result in inappropriate treatment and increased mortality of patients.Differential diagnosis among Mycobacterium species has been made by conventional phenotypic and biochemicaltests after a long culture period. Specialized molecular diagnostics of mycobacteria allows rapid detection and speciesidentification; however, such tests are not available in public health programs.

Oral mucosa as a source of Mycobacterium leprae infection and transmission, and implications of bacterial DNA detection and the immunological status

Publicado no Clinical Microbiology and Infection ª2011 European Society of Clinical Microbiology and Infectious Diseases, CMI, 17, 1653–1658

Ocorrência de reações em pacientes pós-alta por cura de hanseníase: subsídios para implementação de um programa de atenção específica Occurrence of late lepra reaction in leprosy pacients

Publicado no Hansen. Int., 25111: 7-16, 2000