FATORES ASSOCIADOS À RECIDIVA DA HANSENÍASE MULTIBACILAR: UMA REVISÃO INTEGRATIVA

Abstract

The recurrence of multibacillary (MB) leprosy remains a challenge for disease control, even after the introduction of multidrug therapy (MDT). This study aimed to analyze the main clinical, laboratory, and therapeutic factors associated with relapse in patients with MB leprosy. An integrative literature review was conducted in the PubMed, BVS, and SciELO databases. Following the PRISMA guidelines, the initial search of 282 articles resulted in the inclusion of eight studies, totaling 5,732 patients. Data were evaluated through narrative synthesis. Relapse proved to be a rare and predominantly late event, with a mean detection time of approximately ten years after discharge. A high initial Bacillary Index (BI) was the most consistently associated risk factor for recurrence. Other factors identified included the Virchowian and Dimorphous clinical forms and previous treatment for leprosy reactions. The standard 12-month MDT regimen proved effective. A high initial BI was shown to be an important risk marker for relapse. The standardization of diagnostic criteria and the implementation of long-term follow-up strategies for patients with a high bacillary load are recommended.