IMMUNOTHERAPY OF LEPROMIN-NEGATIVE BORDERLINE LEPROSY PATIENTS WITH LOW-DOSE CONVIT VACCINE AS AN ADJUNCT TO MULTIDRUG THERAPY - A 6-YEAR FOLLOW-UP-STUDY IN CALCUTTA

The present report, which describes management of lepromin-negative bo rderline leprosy patients with low-dose Convit vaccine, is an extensio n of our earlier study on the treatment of lepromatous leprosy patient s with low-dose Convit vaccine as an adjunct to multidrug therapy (MDT ). The test Group I, consisting of 50 lepromin-negative, borderline le prosy patients, were given low-dose Convit vaccine plus MDT. The contr ol group II consisted of 25 lepromin-negative, borderline leprosy pati ents given BCG vaccination plus MDT and 25 lepromin-negative, borderli ne leprosy patients given killed Mycobacterium leprae (human) vaccine plus MDT. The control group III consisted of 50 lepromin-positive, bor derline leprosy patients not given any immunostimulation but given onl y MDT Depending upon the lepromin unresponsiveness, the patients were given one to four inoculations of the various antileprosy vaccines and were followed up every 3 months for 2 years for clinical, bacteriolog ical and immunological outcome. All patients belonging to the test and control groups showed clinical cure and bacteriological negativity wi thin 2 years. However, immunologic potentiation, assessed by lepromin testing and the leukocyte migration inhibition test (LMIT), was better in the test patients receiving low-dose Convit vaccine plus MDT than in the control patients receiving BCG vaccine plus MDT or killed M. le prae vaccine plus MDT or MDT alone. But the capacity of clearance bact eria (CCB) test from the lepromin granuloma showed poor bacterial clea rance in the test patients. However, there was no relapse during 6 yea rs of follow up. Two mid-borderline (BB) patients had severe reversal reactions with lagophthalmos and wrist drop during immunotherapy despi te being given low-dose Convit vaccine.