Impact of Human Immunodeficiency Virus on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon

Christinet, Vanessa; Comte, Éric; Ciaffi, Laura; Odermatt, Peter; Serafini, Micaela; Antierens, Annick; Rossel, L; Nomo, Alain-Bertrand; Nkemenang, Patrick; Tsoungui, Akoa; Delhumeau, Cécile; Calmy, Alexandra

doi:10.1093/ofid/ofu021

Cited by 40 publications

(79 citation statements)

References 23 publications

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“…A retrospective study conducted in Cameroon revealed that human immunodeficiency virus (HIV) infection may affect the clinical presentation and severity of BU disease with a reported increased incidence of multiple, larger, and ulcerated BU lesions. [16][17][18] Data available on the absorption of antituberculosis medications in tuberculosis (TB)/HIV coinfection compared with HIV-negative patients showed conflicting results. 19,20 Therefore, whether antimycobacterial combination treatment is less efficacious in persons with HIV infection is unknown and needs to be systematically studied.…”

Section: Introductionmentioning

confidence: 99%

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

Tuffour

Owusu-Mireku

Ruf

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. The synergy between Mycobacterium tuberculosis infection and human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome is well established but not so in Buruli ulcer (BU). We screened confirmed BU cases for HIV infection and followed seven BU/HIV-coinfected patients. Management of BU/HIV was based on the World Health Organization guidelines and patient condition. The HIV positivity among BU patients (8.2%; 11/134) was higher compared with that of general patients attending the facility (4.8%; 718/14,863; P = 0.07) and that of pregnant women alone (2.5%; 279/11,125; P = 0.001). All seven BU/HIV-coinfected cases enrolled in the study presented with very large (category III) lesions with four having multiple lesions compared with 54.5% of category III lesions among HIV-negative BU patients. During the recommended BU treatment with streptomycin and rifampicin (SR) all patients developed immune infiltrates including CD4 T cells in their lesions. However, one patient who received antiretroviral therapy (ART) 1 week after beginning SR treatment developed four additional lesions during antibiotic treatment, while two out of the four who did not receive ART died. Further evidence is required to ascertain the most appropriate time to commence ART in relation to SR treatment to minimize paradoxical reactions.

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Section: Introductionmentioning

confidence: 99%

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

Tuffour

Owusu-Mireku

Ruf

et al. 2015

The American Society of Tropical Medicine and Hygiene

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“…77 Two recent case-control studies carried out in Benin and Ghana reported a significant effect of HIV infection on the severity of M. ulcerans infections and provided evidence suggestive of a higher HIV incidence in patients with BU compared with the general population. 102,103 Furthermore, observations in case studies indicate a more severe disease in HIV patients.…”

Section: Hiv Statusmentioning

confidence: 99%

Epidemiology and disease burden of Buruli ulcer: a review

Röltgen¹,

Pluschke

2015

RRTM

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Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans. Infection foci occur mainly in remote, rural areas of Central and West Africa, but also in Australia and Papua New Guinea. In addition, infections caused by M. ulcerans strains of a different lineage are sporadically reported from scattered foci in Asia and the Americas. While in the past decade more than 42,000 BU cases have been reported worldwide, an assessment of the actual global disease burden is complicated by the remoteness of affected populations and a lack of data on the incidence of BU in a number of countries, from which cases have been historically reported. Moreover, as BU patients present with diverse clinical manifestations ranging from relatively unspecific nodules, plaques, or edema to necrotic, ulcerative lesions, differential diagnosis is manifold and thus clinical misclassification may occur. Since to date reservoirs and transmission pathways of M. ulcerans remain equivocal, early diagnosis and treatment of patients are key determinants to control the disease. Particularly in view of the apparent decline in BU incidence in regions of West Africa, awareness and knowledge of BU in endemic regions must be retained to ensure a continuous monitoring and control. An integrated approach for the control of tropical skin diseases should be considered to cope with this difficult task. This review article aims at providing an overview of the current global burden of BU and summarizes the state of knowledge on the various epidemiological aspects of this enigmatic disease.

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“…The latest is poorly understood, but well documented [3]. IRIS occurs in the setting of Anti-retroviral treatment (ART) initiation and it is considered as a deregulated immunologic response to a previously existing pathogen such as mycobacterium ulcerans in Buruli ulcer.…”

Section: Editorialmentioning

confidence: 99%

Problematic Management of Buruli Ulcer and HIV Co-infection in Tropical Regions

Kassi¹

2015

J Infec Dis Treat

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Impact of Human Immunodeficiency Virus on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon

Cited by 40 publications

References 23 publications

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

Challenges Associated with Management of Buruli Ulcer/Human Immunodeficiency Virus Coinfection in a Treatment Center in Ghana: A Case Series Study

Epidemiology and disease burden of Buruli ulcer: a review

Problematic Management of Buruli Ulcer and HIV Co-infection in Tropical Regions

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