{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:27:34Z","timestamp":1784543254525,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Leprosy reactions, the main cause of neural damage, can occur up to 7 years after starting multidrug therapy. We aimed to approach the prognostic factors that may influence the leprosy reactions over the follow-up time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study, encompassing 10 years of data collection, composed of 390 patients, divided into 201 affected by reactions and 189 reaction-free individuals. Epidemiological, clinical, and laboratory variables were approached as prognostic factors associated with leprosy reactions. The association among variables was analyzed by a binomial test and survival curves were compared by the Kaplan-Meier and Cox proportional-hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>51.5% (201\/390) of patients were affected by leprosy reactions. These immunological events were associated with lepromatous leprosy (16.2%; 63\/390; <jats:italic>p<\/jats:italic> &amp;lt; 0.0001) and multibacillary group (43%; 169\/390; <jats:italic>p<\/jats:italic> &amp;lt; 0.0001). This study showed that survival curves for the prognostic factor anti-PGL-I, comparing positive and negative cases at diagnosis, differed in relation to the follow-up time (Log Rank: <jats:italic>p<\/jats:italic> = 0.0760; Breslow: <jats:italic>p<\/jats:italic> = 0.0090; Tarone-Ware: <jats:italic>p<\/jats:italic> = 0.0110). The median survival times (time at which 50% of patients were affected by leprosy reactions) were 5 and 9 months for those reactional cases with negative (26\/51) and positive serology (75\/150), respectively. The time-dependent covariates in the cox proportional-hazards regression showed anti-PGL-I as the main prognostic factor to predict leprosy reactions (hazard ratio=1.91; <jats:italic>p<\/jats:italic> = 0.0110) throughout the follow-up time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Finally, these findings demonstrated that anti-PGL-I serology at diagnosis is the most important prognostic factor for leprosy reactions after starting multidrug therapy, thus enabling prediction of this immunological event.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.841030","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T07:57:22Z","timestamp":1658735842000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Clinical, epidemiological, and laboratory prognostic factors in patients with leprosy reactions: A 10-year retrospective cohort study"],"prefix":"10.3389","volume":"9","author":[{"given":"Douglas Eul\u00e1lio","family":"Antunes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo Fernandes","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayara Ingrid Sousa","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larissa Pereira","family":"Caixeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meydson Benjamin Carvalho","family":"Correa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilly Caroline dos Santos","family":"Moraes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia Carine Almeida","family":"Concei\u00e7\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Ricardo","family":"Goulart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Maria Bernardes","family":"Goulart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e0005396","DOI":"10.1371\/journal.pntd.0005396","article-title":"Leprosy reactions: the predictive value of Mycobacterium leprae-specific serology evaluated in a Brazilian cohort of leprosy patients (U-MDT\/CT-BR)","volume":"11","author":"Hungria","year":"2017","journal-title":"PLoS Negl Trop Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.6061\/clinics\/2012(10)05","article-title":"Leprosy reactions: coinfections as a possible risk factor","volume":"67","author":"Motta","year":"2012","journal-title":"Clinics."},{"key":"B3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1489\/1544-581X(2004)072<0125:ECOLRY>2.0.CO;2","article-title":"Epidemiological characteristics of leprosy reactions: 15 years experience from north India","volume":"72","author":"Kumar","year":"2004","journal-title":"Int J Lepr Other Mycobact Dis."},{"key":"B4","first-page":"118","article-title":"Relapse or late reversal reaction?","volume":"58","author":"Sehgal","year":"1990","journal-title":"Int J Lepr Other Mycobact Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"637","DOI":"10.4269\/ajtmh.2010.09-0586","article-title":"Reactions following completion of 1 and 2 year multidrug therapy (MDT)","volume":"83","author":"Balagon","year":"2010","journal-title":"Am J Trop Med Hyg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"838","DOI":"10.47391\/JPMA.878","article-title":"Lepra reactions in new leprosy cases at diagnosis: a study of 50 Pakistani patients","volume":"71","author":"Ghafoor","year":"2021","journal-title":"J Pak Med Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s40249-016-0203-0","article-title":"Can baseline ML Flow test results predict leprosy reactions? 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