Leprosy risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Close contacts of patients with untreated, active multibacillary disease are at highest risk of acquiring leprosy. Children are more susceptible than adults to contracting the disease.
Risk Factors
The people with higher risk of acquiring leprosy include:
- Close contacts of leprosy patients.[1]
- The type of leprosy of the contact may affect transmission and lepromatous leprosy patients have higher risk of transmitting the disease.[1][2]
- Immunosuppressed patients have a higher risk of being infected by the mycobacteria. In the particular case of HIV patients, the infection by the HIV has not been noted to increase vulnerability for development of leprosy. Additionally some studies have reported activation of latent mycobacteria leprae with exacerbation of previous lesions, once the antiretroviral therapy is started, possibly due to reconstitution of the immune response against the bacteria.[3][4][5][6][7]
- History of armadillo contact[8]
- Genetic factors - the immune response against the mycobacteria has innate and acquired components. It has been noted that variants of the NOD2-mediated signaling pathway, a regulator of the innate component, have a higher risk of developing leprosy.[9][10]
- Age - According to one study, there is a bimodal distribution of incidence, with increased risk between the ages of 5 and 15 years, and than another increase after the age of 30.[11]
- Patients living in endemic regions and with poor-higiene and nutritional conditions.[12]
References
- ↑ 1.0 1.1 van Beers SM, Hatta M, Klatser PR (1999). "Patient contact is the major determinant in incident leprosy: implications for future control". Int J Lepr Other Mycobact Dis. 67 (2): 119–28. PMID 10472363.
- ↑ Eiglmeier K, Parkhill J, Honoré N, Garnier T, Tekaia F, Telenti A; et al. (2001). "The decaying genome of Mycobacterium leprae". Lepr Rev. 72 (4): 387–98. PMID 11826475.
- ↑ Trindade MA, Palermo ML, Pagliari C, Valente N, Naafs B, Massarollo PC; et al. (2011). "Leprosy in transplant recipients: report of a case after liver transplantation and review of the literature". Transpl Infect Dis. 13 (1): 63–9. doi:10.1111/j.1399-3062.2010.00549.x. PMID 20678090.
- ↑ Martiniuk F, Rao SD, Rea TH, Glickman MS, Giovinazzo J, Rom WN; et al. (2007). "Leprosy as immune reconstitution inflammatory syndrome in HIV-positive persons". Emerg Infect Dis. 13 (9): 1438–40. doi:10.3201/eid1309.070301. PMC 2857291. PMID 18252138.
- ↑ Sarno EN, Illarramendi X, Nery JA, Sales AM, Gutierrez-Galhardo MC, Penna ML; et al. (2008). "HIV-M. leprae interaction: can HAART modify the course of leprosy?". Public Health Rep. 123 (2): 206–12. PMC 2239330. PMID 18457073.
- ↑ Deps PD, Lockwood DN (2008). "Leprosy occurring as immune reconstitution syndrome". Trans R Soc Trop Med Hyg. 102 (10): 966–8. doi:10.1016/j.trstmh.2008.06.003. PMID 18639911.
- ↑ Couppié P, Domergue V, Clyti E, El Guedj M, Vaz T, Sainte-Marie D; et al. (2009). "Increased incidence of leprosy following HAART initiation: a manifestation of the immune reconstitution disease". AIDS. 23 (12): 1599–600. doi:10.1097/QAD.0b013e32832bb5b7. PMID 19487911.
- ↑ Truman, Richard W.; Singh, Pushpendra; Sharma, Rahul; Busso, Philippe; Rougemont, Jacques; Paniz-Mondolfi, Alberto; Kapopoulou, Adamandia; Brisse, Sylvain; Scollard, David M.; Gillis, Thomas P.; Cole, Stewart T. (2011). "Probable Zoonotic Leprosy in the Southern United States". New England Journal of Medicine. 364 (17): 1626–1633. doi:10.1056/NEJMoa1010536. ISSN 0028-4793.
- ↑ Alter A, Alcaïs A, Abel L, Schurr E (2008). "Leprosy as a genetic model for susceptibility to common infectious diseases". Hum Genet. 123 (3): 227–35. doi:10.1007/s00439-008-0474-z. PMID 18247059.
- ↑ Zhang FR, Huang W, Chen SM, Sun LD, Liu H, Li Y; et al. (2009). "Genomewide association study of leprosy". N Engl J Med. 361 (27): 2609–18. doi:10.1056/NEJMoa0903753. PMID 20018961.
- ↑ Moet FJ, Pahan D, Schuring RP, Oskam L, Richardus JH (2006). "Physical distance, genetic relationship, age, and leprosy classification are independent risk factors for leprosy in contacts of patients with leprosy". J Infect Dis. 193 (3): 346–53. doi:10.1086/499278. PMID 16388481.
- ↑ Bhat, Ramesh Marne; Prakash, Chaitra (2012). "Leprosy: An Overview of Pathophysiology". Interdisciplinary Perspectives on Infectious Diseases. 2012: 1–6. doi:10.1155/2012/181089. ISSN 1687-708X.