Association between leprosy and HIV infection in Tanzania
van den Broek, J.; Chum, H.J.; Swai, R.; O'Brien, R.J.
International journal of leprosy and other mycobacterial diseases official organ of the International Leprosy Association 65(2): 203-210
1997
ISSN/ISBN: 0148-916X PMID: 9251592 Document Number: 270747
The association between HIV infection and leprosy was investigated in 731 consecutive leprosy cases from all 20 regions of Tanzania. These cases represented 69% of total notified new and relapsed leprosy cases reported in the 1991-93 study period. HIV prevalence among the 679 patients for whom complete data were available was 12% (83 cases). Leprosy patients aged 35-54 years and those without a BCG scar were significantly less likely than their counterparts aged 15-34 years and those with a BCG scar to be HIV-infected. There were no significant differences in HIV prevalence in terms of sex, urban or rural residence, new or relapsed cases, and paucibacillary or multibacillary leprosy. Among controls--all 158,971 blood donors tested for HIV during 1991 to 1993--HIV prevalence was 6%. The overall odds ratio for HIV infection among leprosy patients compared with controls, after adjustments for sex, age, and residence, was 2.5 (95% confidence interval, 2.0-3.2). Point estimates of the attributable risk and the population attributable risk were 57% and 7%, respectively. These findings indicate that HIV infection significantly increases the risk of leprosy in Tanzania and compromises the protective effect of BCG vaccination. Although case notifications of leprosy in Tanzania have not changed appreciably in the past 13 years, expansion of the HIV epidemic could have a significant effect on the epidemiology of leprosy.