Clinical, epidemiological, and laboratory prognostic factors in patients with leprosy reactions: A 10-year retrospective cohort study
Leprosy reactions, the main cause of neural damage, can occur up to 7 years after starting multidrug therapy. We aimed to approach the prognostic factors that may influence the leprosy reactions over the follow-up time. Retrospective cohort study, encompassing 10 years of data collection, composed o...
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| Published in: | Frontiers in medicine Vol. 9; p. 841030 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Switzerland
Frontiers Media S.A
25-07-2022
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Leprosy reactions, the main cause of neural damage, can occur up to 7 years after starting multidrug therapy. We aimed to approach the prognostic factors that may influence the leprosy reactions over the follow-up time.
Retrospective cohort study, encompassing 10 years of data collection, composed of 390 patients, divided into 201 affected by reactions and 189 reaction-free individuals. Epidemiological, clinical, and laboratory variables were approached as prognostic factors associated with leprosy reactions. The association among variables was analyzed by a binomial test and survival curves were compared by the Kaplan-Meier and Cox proportional-hazards regression.
51.5% (201/390) of patients were affected by leprosy reactions. These immunological events were associated with lepromatous leprosy (16.2%; 63/390;
< 0.0001) and multibacillary group (43%; 169/390;
< 0.0001). This study showed that survival curves for the prognostic factor anti-PGL-I, comparing positive and negative cases at diagnosis, differed in relation to the follow-up time (Log Rank:
= 0.0760; Breslow:
= 0.0090; Tarone-Ware:
= 0.0110). The median survival times (time at which 50% of patients were affected by leprosy reactions) were 5 and 9 months for those reactional cases with negative (26/51) and positive serology (75/150), respectively. The time-dependent covariates in the cox proportional-hazards regression showed anti-PGL-I as the main prognostic factor to predict leprosy reactions (hazard ratio=1.91;
= 0.0110) throughout the follow-up time.
Finally, these findings demonstrated that anti-PGL-I serology at diagnosis is the most important prognostic factor for leprosy reactions after starting multidrug therapy, thus enabling prediction of this immunological event. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Cleverson Teixeira Soares, Instituto Lauro de Souza Lima, Brazil Reviewed by: Tarun Narang, Postgraduate Institute of Medical Education and Research, India; Vânia Nieto Brito De Souza, Instituto Lauro de Souza Lima, Brazil; Shankargouda Patil, Jazan University, Saudi Arabia These authors have contributed equally to this work This article was submitted to Infectious Diseases-Surveillance, Prevention and Treatment„ a section of the journal Frontiers in Medicine |
| ISSN: | 2296-858X 2296-858X |
| DOI: | 10.3389/fmed.2022.841030 |