Leprosy Mailing List – January 6, 2020
Ref.: (LML) Dapsone allergy and MB treatment
From: Shen Jianping, Nanjing, China
Dear Dr Pieter Schreuder,
Happy New Year 2020.
I have a question about MB leprosy treatment in China. Now in China, all newly detected leprosy patients are checked for dapsone allergy, 1301 gene-locus for possible DDS syndrome.
The 1301 gene-locus positivity among the newly detected patient is 28%, but in past the incidence of Dapsone syndrome was only 2-3% each year in China. That means that 28 % of new leprosy patients, most were MB patients, are treated with only two drugs, rifampicin and clofazimine for one year. We do not know if there is a risk for treatment failure. A paper from Yunnan province, China, reported that the BI declined very slowly among patients with 1301 gene-locus positivity, and treated with only two drugs.
I remember that WHO once recommended that a leprosy patient with dapsone allergy can be treated with two drugs only, rifampicin and clofazimine. This recommendation is still effective now? In 2018, WHO recommended that PB patients would be treated with 3 drugs, but we now use only two drugs to treat MB leprosy.
Thank you and all for your suggestions and advice,
Dr Shen Jianping
Professor, National Center for Leprosy Control
Nanjing PR China
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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