Prevalence of autoantibodies against cellular antigens in patients with HIV and leprosy coinfection in the Amazon region

Abstract

BackgroundInfectious agents can activate self-reactive T cells. In general, infections trigger various mechanisms, including a lack of auto-tolerance, induction of costimulatory molecules on antigen presenting cells, and molecular simulation, in addition to cross-reactions between microbial antigens and self-antigens. HIV and leprosy coinfections lead to self-immunity with the production of autoantibodies. However, not enough data on the immune behaviour associated with this coinfection are available. Therefore, this study focused on the detection of autoantibodies against cellular antigens (AACA) in individuals with HIV and leprosy coinfection in the Amazon region.MethodsPatients were distributed into four groups according to their infections: (i) coinfection with HIV and leprosy (n = 23), (ii) infection with leprosy (n = 33), (iii) infection with HIV/AIDS (n = 25), and (iv) healthy blood donor controls (n = 100). AACA were identified by indirect immunofluorescence and the samples were tested using a commercial diagnosis kit containing the antinuclear antibody HEp-2.ResultsMorphologically, all stages of cell division were assessed in addition to the morphological features associated with the nuclear matrix, nucleolus, mitotic spindle, and cytoplasm. There was a high prevalence of AACA in the coinfection group (47.8%, n = 11) when compared with the control group of healthy blood donors (2.0%). The results showed predominantly cytoplasmic staining in all groups analysed, and no difference was observed between the presence or absence of AACA and the leprosy forms (paucibacillary and multibacillary) in the coinfection group.ConclusionsThe results of this study show that despite the tendency of coinfected patients to have higher levels of autoantibodies, no correlation was observed between clinical and laboratorial variables and morbidity associated with HIV and leprosy coinfections or the levels of AACA in the serum of coinfected patients. These data are important to elucidate this complex relationship between HIV and leprosy and thus improve the follow-up of these patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0294-2) contains supplementary material, which is available to authorized users.

Hanseníase na Amazônia central: um olhar epidemiológico

“…Apesar de não bem esclarecido, a associação de aspectos individuais e ambientais pode propiciar resistência, tornando-a mais preocupante pela subdetecção desses pacientes 29 . De causa pouco esclarecida também, está a relação da coinfecção do Vírus da Imunodeficiência Humana (HIV) e hanseníase, em que os pacientes expressam maior número de autoanticorpos que, quando em circulação, podem depositar-se nos órgãos ativando o Sistema Complemento levando a processos inflamatórios 30 .…”

Peripheral nerve abnormality in HIV leprosy patients

“…Other studies in our group, using other tools and some instigating data, point to the need for simplified but more specific tools for the management of coinfected patients, especially in areas where diseases occur endemically [ 1 – 2 , 6 ], whose data are available and not yet published [ 45 , 46 ].…”

“…In 2016, Pará had the 4th highest detection rate among Brazilian states, and its capital, Belém, had the 3rd highest detection rate (55.4/100,000 inhabitants) among Brazilian capitals [ 2 ]. The geographical overlap of the two diseases has become increasingly present and worrisome, which raises questions about how the health professionals address the clinical management and therapeutics of an individual coinfected by both diseases [ 3 – 6 ].…”