Leprosy Reversal Reaction as Immune Reconstitution Inflammatory Syndrome in Patients with AIDS

We report 2 instances in which reactional borderline leprosy manifested itself as an immune reconstitution phenomenon in patients with acquired immunodeficiency syndrome. We discuss the clinical, laboratory-based, histopathologic, and immunohistochemical characteristics of both patients. Fur-thermore, we review similar reports from the literature. Ten percent to 25 % of patients who commence HAART ex-perience immune reconstitution inflammatory syndrome (IRIS), which is characterized by the presence of clinical man-ifestations of previously latent infection after improvement of the immune system resulting from antiretroviral therapy [1, 2]. There have been reports of tuberculosis [3, 4], herpes zoster [5], cytomegalovirus infection [6], Mycobacterium avium com-plex infection [7], hepatitis B [8] and C [9], and other infections described as immune reconstitution processes. Leprosy ha