A FOLLOW-UP-STUDY OF MULTIBACILLARY HANSENS-DISEASE PATIENTS TREATED WITH MULTIDRUG THERAPY (MDT) OR MDT PLUS IMMUNOTHERAPY (IMT)

Multibacillary (MB) leprosy patients treated with multidrug therapy (M DT) or MDT + immunotherapy (IMT) with BCG + heat-killed Mycobacterium leprae were tested annually for their ability to proliferate in vitro to the mycobacterial antigens BCG, M. leprae soluble extract, and inta ct M. leprae. IgM antibody responses to phenolic glycolipid I (PGL-I) were measured, as well as serum nitrite levels in patients' sera, befo re, during and after treatment. Patients who received only MDT did not present cellular reactivity to intact M. leprae antigens, in contrast to the results obtained with BCG, which elicited reactivity at time z ero, that increased after treatment. Regarding PGL-I antibody variatio ns in relation to the initial value, we observed a statistically signi ficant marked decrease at the end of 2 years which continued to fall i n successive evaluations. MB patients showed high initial serum nitrit e concentrations which dropped drastically with treatment, This decay was apparently associated with the bacillary load present in these pat ients, The group submitted to IMT + MDT showed high and long-lasting T -cell responses to mycobacterial antigens in a significant number of i nitially unresponsive MB patients, There was a marked increase to M. l eprae soluble extract and BCG, as well as a more variable response to whole bacilli. The antibody levels in this group of patients are susta ined for a somewhat longer period and decreased more slowly during the 5-year follow up.