The effect of HIV status on the clinical picture of leprosy: a prospectivestudy in Ethiopia

No major interaction between HIV infection and leprosy has been documented. The ALERT MDT Field Evaluation Study (AMFES) has allowed the examination o f possible interactions in a prospective manner, although the total number of HIV-positive individuals was not high at 22 (3.8%) of 581 patients teste d. There was an excess number of deaths in the HIV-positive group: 27% comp ared with 5.7% in the HIV-negative group, although the causes of death were not recorded (relative risk 4.8; 95% CI 2.2-10.2). HIV-positive individual s had a higher risk of EM, reactions (relative risk 5.2; 95%, CI 1.7-15.9). Reversal reactions and neuritis (both acute and chronic) were not signific antly influenced by HIV status, although there was a possible increase in r ecurrent reversal reactions in HIV-positive cases (relative risk 22; 95% CI 0.98-4.7). There was no evidence to suggest an increased risk of developin g leprosy or of developing multibacillary rather than paucibacillary diseas e. There was no association between HIV positivity and the development of i mpairment.