Leprosy Mailing List, December 20, 2024
Ref.: (LML) Lepromatous leprosy – treat lifelong!
From: Ben Naafs, Munnekeburen, the Netherlands
Dear Pieter,
I have reread a number of contributions to LML of Joel Almeida. Sometimes his contributions are confronting for some. But there is one thing I think he wants to explain. That is the way we handle our patients at present is not leading to less infections in endemic areas in the future.
I fully agree with him that that post exposure prophylaxis is not enough for downgrading and lepromatous patients and that certainly polar lepromatous patients should be treated for life. For BL and subpolar lepromatous patients who are downgraded till they started treatment. However, treatment of only 1 year is not enough. Because they will either be reinfected or have a relapse. They should be treated for, let's say the number of years their BI is at diagnosis. Thereafter their CMI should be increased by vaccination. Not once but repeatedly, the interval should be researched. This is not like in most PEP research, only a follow up for a few years. But a lifelong follow up. Then they will not spread bacilli after so-called being cured.
Ben
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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