Mycobacterium leprae particle agglutination in diagnosis and monitoring of treatment of leprosy.

IgM antibody levels against PGL-1 antigen were measured by M. leprae particle agglutination (MLPA) in 156 untreated leprosy patients. The seropositivity rate was much higher in newly untreated MB patients (84.7%) than in PB patients (19.7%). The mean MLPA titers in MB and PB declined significantly after 1 month of MDT (p < 0.001). Seropositivities in control serum specimens were 11.3 per cent in active pulmonary tuberculosis patients, 2.6 per cent in dermatologic patients and 4.4 per cent in a healthy population, in low titers. The study confirms that, anti PGL-1 assay using MLPA is a sensitive and specific diagnostic tool for the diagnosis of leprosy especially MB patients. Additionally, it provides an alternative tool in monitoring leprosy patients under MDT.

Ofloxacin containing combined drug regimens in the treatment of multibacillary leprosy.

The results of ofloxacin containing combined drug regimens in the treatment of 60 multibacillary leprosy cases from January 1989 to June 1995 are reported. The objective of the trial is to compare the antileprotic property of ofloxacin and rifampicin in multibacillary leprosy patients and to study the killing rate of M. leprae by ofloxacin and rifampicin before mass treatment can be recommended. The complications and side-effects of ofloxacin and rifampicin were of a mild nature and both drugs were well tolerated. Moderate to marked clinical improvement was noticed in a short period with ofloxacin containing regimens in multibacillary leprosy patients. No persisters were detected in any of the 33 specimens (of mouse footpads) that had been obtained after treatment for 6 months. Ofloxacin if added to the currently used WHO recommended MB-MDT regimen may shorten the duration of treatment. Ofloxacin, therefore, may be considered as a suitable alternative in suspected/proven rifampicin resistant cases and where rifampicin is contraindicated. The results were evaluated on the basis of the clinical conditions, mycobactericidal effectiveness, signs of drug toxicity and side effects.

Anti-PGL-1 antibody levels in Thai leprosy patients.

Phenolic glycolipid - 1 (PGL-1) is a Mycobacterium leprae specific cell wall component. It is an immunodominant antigen and can induce a strong humoral immune response. IgM antibody levels against PGL-1 were measured in Thai leprosy patients between October 1992-April 1994 by a commercially available M. leprae particle agglutination test (MLPA). The percentage of seropositivity was much higher in newly untreated multibacillary (MB) patients (83.9%) than in paucibacillary (PB) patients (17.8%). Antibody levels in the MB group varied in the range 32-8,192, whereas they varied in the range 32-256 in the PB group. Patients being treated with multidrug therapy (MDT) were 68.3% and 19.4% seropositive in the MB and PB groups, respectively. Seropositivities in control serum specimens were 11.3% in active pulmonary tuberculosis patients, 2.6% in dermatologic patients and 4.4% in a healthy population. In conclusion, the anti-PGL-1 assay using MLPA appears to be a sensitive and specific diagnostic tool for the diagnosis of MB patients. Additionally, it may provide an alternative to the BI determination in monitoring MB patients under MDT, and also in the surveillance of such patients after MDT.

Combined chemotherapy trials with regimens containing ofloxacin and rifampicin for multibacillary leprosy patients.

The results of combined chemotherapy trials with regimens containing ofloxacin and rifampicin for the treatment of 60 multibacillary leprosy cases from January 1989 to September 1995 was reported. Clinical improvement was achieved by all regimens from the end of the first month. Most patients continued to improve for 3 years. Bacterial indices were gradually reduced during the treatment. Patients on regimens containing rifampicin were clear of M. leprae at the end of the 5th year. The complications and side-effects of ofloxacin and rifampicin were trivial and both drugs were well tolerated. Ofloxacin added to the current WHO recommended M.B.-MDT regimen may shorten the duration of treatment. Ofloxacin may be an alternative in suspected/proven rifampicin resistant cases or rifampicin contraindicated.