Impact of MDT/WHO on hematological and liver tests in patients with leprosy

• Grant number: 23/17467-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2024
• End date: July 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Marco Andrey Cipriani Frade
• Grantee: Cláudio Mariano da Silva
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which infects skin cells and peripheral nerves. The main consequence of the disease is deformities leading to physical disability. The difficulties experienced in the daily practice of health services regarding the diagnosis of different clinical forms, reaction states and the early identification of infected contacts are important factors that do not allow us to control the magnitude of this disease in Brazil. The diagnosis can be made clinically, taking the patient's history and noticing changes in the physical examination, in addition to the aid of complementary tests, such as laboratory tests of Elisa IgM anti-PGL-1 serology, RLEP-DNA examination of M. leprae by PCR and sputum smear microscopy of cold areas (knee, elbow and ear), and tests such as electroneuromyography and ultrasound of peripheral nerves with transverse measurements of the nerves. Treatment is done with a multibacillary polychemotherapy regimen (MQT/WHO-MB) consisting of three drugs: dapsone, rifampicin and clofazimine. These drugs generate some adverse effects, which can become symptomatic and stigmatizing for patients, namely: hemolytic anemia due to dapsone, liver disease due to rifampicin, and cutaneous hyperpigmentation due to clofazimine. The present study aims to retrospectively analyze the hematimetric indices and liver function indices of patients undergoing treatment for leprosy at the University of São Paulo at Ribeirão Preto School of Medicine Hospital das Clínicas (HC-FMRP/USP) between 2001 and 2020, in order to evidence laboratory alterations generated by the adverse effects of MDT/WHO. Thus, through the HC-FMRP/USP Information Center, data from patients diagnosed with leprosy will be obtained, including information on complete blood count tests, liver function indices (AST/ALT, Alkaline Phosphatase and Gamma GT), G6PD dosages and molecular biology for the detection of M. leprae DNA by PCR. The indices will be analyzed according to the evolution of the treatment, initially measured as soon as the patient arrives at the outpatient clinic (new case), and after the 1st, 3rd, 6th and 12th month of treatment. Thus, statistical tools can be used to evaluate possible hematological and hepatic alterations with the use of MDT/WHO.