Viral co‐infections in leprosy: a scoping review

Abstract

ContextThe most reported viral co-infections in leprosy are human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV), hepatitis B virus (HBV), hepatitis C virus (HCV), and SARS-CoV-2. In co-infections, the burden of an agent can be increased or decreased by the presence of others. To address this issue, we need to fully understand their prevalence, risk factors, immunology, clinical manifestations, and treatment. The purpose of this scoping review is to describe the clinical and epidemiological characteristics of the most reported viral co-infections in leprosy to inform clinicians and guide future research. MethodsThe authors conducted a literature search of five databases for articles on each of the aforementioned co-infections published prior to October 2022. Two independent reviewers conducted the selection process and identified 53 papers meeting the study inclusion criteria. The data extraction process and evidence synthesis were conducted by one reviewer and double-checked by a second one, consistent with best practice recommendations for scoping reviews.Results For all assessed viruses, most studies reported prevalence rates in leprosy patients higher than the general population. Studies found that HTLV, HBV, and HCV chronic infections were highest in multibacillary leprosy, whereas HIV was mostly found in paucibacillary leprosy, and SARS-Cov-2 affected leprosy subtypes equally. Overall, coinfections were also associated with higher rates of leprosy reactions, except for COVID-19. Forty-six percent of the studies discussed issues related to treatment, which led to favorable outcomes for the most part.Conclusions This review summarizes the existing literature on viral co-infections in leprosy patients, generating valuable insights and recommending areas for future research.

Comorbidities and Complications in People Admitted for Leprosy in Spain, 1997–2021

“…The prevalence rates of hepatitis B and hepatitis C in leprosy patients are higher than in the general population [36]. In our study, the prevalence of hepatitis B and hepatitis C was 2.5% and 4.1%, respectively, while in Spain, the prevalence of hepatitis C was 0.2% and hepatitis B was 0.1% [37,38] and vaccination was implemented in 1994 for all newborns.…”

“…Each prevalence was lower than in leprosy patients. A recent meta-analysis also found that these co-infections were associated with higher rates of leprosy reactions [36]; unfortunately, we were unable to make this comparison in our study. Additionally, we observed a slight increase in hepatitis B co-infections and neuropathy in patients with leprosy.…”

Bacterial, fungal and parasitic co-infections in leprosy: A scoping review

“…Disseminated strongyloidiasis can also occur in patients with AIDS, although less frequently than in those with HTLV [ 83 ]. Because both HIV and HTLV are known to affect leprosy patients more frequently than the general population [ 84 ], we recommend that all newly diagnosed leprosy patients undergo routine stool examinations, and that prophylactic treatment with Ivermectin, at a dose of 200 μg/kg/day for 2 days, be administered to all patients beginning corticosteroid therapy, with repeat doses given after 2 weeks [ 85 ].…”