Relapse after long-term follow up of multibacillary patients treated by WHO multidrug regimen

P. Jamet, B. Ji, L. Blanc, P. Bobin, D. Daumerie, G. Discamps, O. C. Faye, G. Grossetete, J. A. Husser, A. Mahe, M. Nebout, S. Pattyn, S. Sow, I. Traore, J. Grosset

Research output: Contribution to journalArticlepeer-review

Abstract

Thirty-five multibacillary (MB) leprosy patients were treated with 2 years of multidrug therapy (MDT) and followed up regularly for relapse. Relapse was defined as: a) an increase of the bacterial index (BI) by 2+ over the previous value from any single site of old lesions and b) the occurrence of definite new skin lesion(s) which demonstrated a higher BI than any pre- existing lesion. After a mean duration of 72.7 ± 17.3 months of follow up per patient, seven relapses were diagnosed; the mean incubation period of relapse was 62.7 ± 18.7 months. The overall relapse rate was 20.0% (or 3.3 per 100 patient-years), very significantly higher than the figures obtained from the same group of patients analyzed 2 1/2 years earlier, indicating that relapses occurred late (at least 5 ± 2 years) after stopping MDT. Further analysis indicated that the relapse rate was closely correlated with the bacterial load of the patient, occurring far more frequently among patients with a BI of ≥4.0 before MDT or with a BI of ≥3.0 at the end of MDT. To avoid the alarmingly high relapse rate, it is proposed that the duration of MDT be doubled to 4 years in patients with an average BI of ≥4.0 before MDT.

Original languageEnglish (US)
Pages (from-to)195-201
Number of pages7
JournalInternational Journal of Leprosy
Volume63
Issue number2
StatePublished - Jan 1 1995

ASJC Scopus subject areas

  • Dermatology

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