Hepatitis B antigen, hepatitis B antibody, and subtypes in leprosy

Hepatitis-B virus infection in patients with leprosy: a serological study in a leprosarium in Northern Nigeria

The prevalence rates of hepatitis-B surface antigen (HGsAg) and its homologous antibody (anti-HBs) were determined in 62 patients in a leprosarium (42 tuberculoid and 20 lepromatous) and in 40 adults living near the locality. The exposure rate (HBsAg + anti-HBs) was high in both controls and patients, 72.5% and 70.9% respectively, The frequency of HBsAg was significantly higher in patients with lepromatous leprosy (40%) compared with controls (10%) (chi 2 = 5.7 p less than 0.025) but there was no difference in the prevalence rate of HBsAg between patients with lepromatous leprosy (40%) compared with those with tuberculoid leprosy (23.8%) (chi 2 = 1.7 p greater than 0.1). The exposure rate was higher in the lepromatous group (80%) compared with the tuberculoid group (59.5%) but the difference was not significant (chi 2 = 2.87 p greater than 0.05). It is concluded that the high rate of infection in patients with leprosy if not due to a peculiar genetic defect but the result of living in an environment where the virus is highly endemic. The observed significance increase in carriage of HBsAg in lepromatous leprosy is probably due to depressed cellular immune function characteristic of this group of patients. The slightly increased exposure rate to HBV of lepromatous versus the tuberculoid type of leprosy is probably due to increased opportunity for infections from repeated and prolonged stay in hospital.

Polymorphonuclear cell function in the various polar types of leprosy and erythema nodosum leprosum

Polymorphonuclear leukocyte motility, both in vivo and in vitro, and reduction of Nitro Blue Tetrazolium was studied in tuberculoid and lepromatous leprosy patients and a group of lepromatous patients with erythema nodosum leprosum (ENL). A profound defect in random migration, chemotaxis, and chemokinesis was found in lepromatous patients with and without complicating ENL, and marked depletion of skin window migration confirmed these in vitro findings. Tuberculoid patients exhibited a mild defect in polymorphonuclear leukocyte motility. Serum inhibitors of normal polymorphonuclear leukocyte chemotaxis were found in all types of leprosy, but sera from lepromatous and ENL patients were most inhibitory. Resting levels of Nitro Blue Tetrazolium reduction were normal in all three groups. Reconstitution of polymorphonuclear leukocyte cells from normal and ENL patients with ENL serum, however, showed increased Nitro Blue Tetrazolium reduction well above the normal range, whereas reconstitution with normal, lepromatous, and tuberculoid sera failed to increase Nitro Blue Tetrazolium reduction above the normal values.