Detection of Mycobacterium leprae DNA by polymerase chain reaction in the blood of individuals, eight years after completion of anti-leprosy therapy

Memórias do Instituto Oswaldo Cruz

Adalberto Rezende Santos²  Vivian Balassiano¹  Maria Leide W Oliveira¹  Marcia Aparecida Da Silva Pereira¹  Patricia Barros Santos¹  Wim Maurits Degrave¹  Philip Noel Suffys¹ 

[1] ,Instituto Oswaldo Cruz-Fiocruz Departamento de Medicina Tropical Setor de Hanseníase

关键词: Mycobacterium leprae;    PCR;    diagnosis;    therapy;    post-treatment;    paucibacillary;    leprosy;   

DOI  :  10.1590/S0074-02762001000800017

来源: SciELO

【 摘 要 】

Thirty eight patients with indeterminate leprosy (HI), at least 4 to 6 years after discharge from multibacillary (MB) or paucibacillary (PB) schemes of anti leprosy multidrug therapy (MDT), were submitted to traditional diagnostic procedures for leprosy and to polymerase chain reaction (PCR) analysis of different clinical samples for detection of Mycobacterium leprae DNA. No significant difference was observed for any of the parameters analyzed between PB or MB schemes of treatment and no indications were found for more efficient outcome of HI using the MB scheme. Remarkably, 18 (54.5%) of the individuals were PCR positive in at least one of the samples: positivity of PCR was highest in blood samples and four individuals were PCR positive in blood and some other sample. Upon comparison of PCR results with clinical and histopathological parameters, no correlation was found between PCR-positivity and eventual relapse. This is the first report on detection of M. leprae DNA in PB patients, more than half a decade after completion of MDT, suggesting that live bacilli are present and circulating much longer than expected, although reinfection of the individuals can not be excluded. Overall, we feel that because of the high sensitivity of the assay, extreme care should be taken about association of PCR results, efficacy of treatment and disease status.

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