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]
- Type of leprosy of the contact - according to some studies, lepromatous leprosy patients have higher risk of transmitting the disease.[1][2]
- Immunosuppression - Immunosuppressed patients have a higher risk of being infected by the mycobacteria.[3][4]
- History of armadillo contact[5]
- 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 higher risk of having leprosy.[6][7]
- 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.[8]
- At highest risk are those living in endemic areas with poor conditions such as inadequate bedding, contaminated water and insufficient diet, or other diseases (such as HIV) that compromise immune function. Recent research suggests that there is a defect in cell-mediated immunity that causes susceptibility to the disease. Less than ten percent of the world's population are actually capable of acquiring the disease. The region of DNA responsible for this variability is also involved in Parkinson's disease, giving rise to current speculation that the two disorders may be linked in some way at the biochemical level. Professional studies show little evidence that HIV is an important factor in increasing the risk of leprosy infection,[9][10] but the potential is under active review.[11][12]
- In addition, men are twice as likely to contract leprosy as women.
- Close contacts with patients with untreated, active, predominantly multibacillary disease.
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.
- ↑ 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.
- ↑ Lewis, F. S. et al. ; Dermatologic Manifestations of Leprosy Clinical Presentation
- ↑ Pönnighaus, J. K.; et al. (1994). "Is HIV Infection a Risk Factor for Leprosy?". International Journal of Leprosy and Other Mycobacterial Diseases. 62 (4): 610–613. PMID 2071978.
- ↑ Batista, M. D.; et al. (2008). "Leprosy reversal reaction as immune reconstitution inflammatory syndrome in patients with AIDS". Clin Infect Dis. 46 (6): e56–60. doi:10.1086/528864. ISSN 1537-6591. PMID 18269334.
- ↑ Menezes, V. M.; Sales, A. M.; Illarramendi, X.; et al. (2009). "Leprosy reaction as a manifestation of immune reconstitution inflammatory syndrome: a case series of a Brazilian cohort". AIDS. 23 (5): 641–643. doi:10.1097/QAD.0b013e3283291405. PMID 19525622.