{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T21:10:45Z","timestamp":1774386645366,"version":"3.50.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014114","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000}}],"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021159","name":"Key Laboratory of Sedimentary Mineralization and Sedimentary Minerals in Shandong Province","doi-asserted-by":"publisher","award":["2023CXGC010507"],"award-info":[{"award-number":["2023CXGC010507"]}],"id":[{"id":"10.13039\/501100021159","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Joint Innovation Team for Clinical & Basic Research","award":["202410"],"award-info":[{"award-number":["202410"]}]},{"DOI":"10.13039\/501100010029","name":"Taishan Scholar Foundation of Shandong Province","doi-asserted-by":"publisher","award":["tsqn202507375"],"award-info":[{"award-number":["tsqn202507375"]}],"id":[{"id":"10.13039\/501100010029","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      In\n                      <jats:italic>HLA-B*13:01<\/jats:italic>\n                      -positive multibacillary (MB) leprosy patients, dapsone-containing multidrug therapy (MDT) carries a high risk of dapsone hypersensitivity syndrome (DHS). Alternative regimens (dapsone-free) are adopted, but their long-term efficacy compared with standard MDT in\n                      <jats:italic>HLA-B*13:01<\/jats:italic>\n                      -negative patients remains inadequately characterized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study analyzed MB patients (2015\u20132023) from the National Leprosy Prevention and Control Management Information System (LEPMIS) with \u22651-year follow-up. Primary outcomes (cure\/relapse rates, bacterial index (BI), leprosy reactions, and disability progression) and secondary outcomes (adverse events and treatment duration) were compared between\n                      <jats:italic>HLA-B*13:01<\/jats:italic>\n                      -positive patients receiving alternative therapy (rifampicin\u2009+\u2009clofazimine\u2009\u00b1\u2009clarithromycin\/ofloxacin\/minocycline) and negative patients receiving standard MDT (rifampicin\u2009+\u2009clofazimine\u2009+\u2009dapsone).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Among the 271 enrolled MB patients (120\n                      <jats:italic>HLA-B*13:01<\/jats:italic>\n                      -positive, 151 negative), alternative therapy showed comparable efficacy to standard MDT in cure rates (67.6% vs. 65.8% at Year 5), the rate of BI decline (89.92% vs. 95.11% at Year 5), smear negativity rates (71.43% vs. 75.00% at Year 5) and relapse rates (0.46 vs. 0.20 per 100 person-years). Kaplan-Meier survival functions revealed no significant differences in leprosy reactions or disability progression. Additionally, alternative therapy demonstrated comparable safety to MDT (1.67% vs. 2.65%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In our study, dapsone-free alternative regimens demonstrated comparable clinical efficacy and safety to standard MDT in MB patients, providing a viable option for\n                      <jats:italic>HLA-B*13:01<\/jats:italic>\n                      carriers. These findings, limited by the observational design and regimen heterogeneity, warrant further investigation in prospective trials.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014114","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:34:31Z","timestamp":1773768871000},"page":"e0014114","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of alternative therapy in HLA-B* 13:01 positive leprosy patients without dapsone versus standard MDT in negative patients: A comparative effectiveness 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