Leprosy Mailing List – January 7th, 2007
Ref.: Treatment of
type one reaction (reversal reaction) in HIV positive patients.
From: Naafs B., Munnekeburen,
The Netherlands
Dear Salvatore,
Concerning the question of Dr Bhattarai from Pokhara and the
reaction from Pran Das who mentioned my name. I indeed have some experience
with double infected patients.
What I would like to know from our colleague is whether
the patient developed the reaction when he got his HAART. A Type 1 leprosy reaction as
an IRIS (Immune Reconstitution Inflammatory Syndrome) is regularly
seen.
The treatment of such an HIV infected leprosy patient is the
same as that of a not HIV infected patient (MDT with prednisolone).
There may be some interaction with the immune restoration, but that
seems to be temporarily and seems not to influence the final
outcome for HIV and other related conditions.
Care must be taken that prednisolone is given long enough,
the initial dosage usually need to exceed the 0.5 mg/kg.
With
kind regards,
Dr Ben
Naafs
