02202nas a2200205   4500000000100000008004100001653001400042653003900056653000800095653001700103653001700120100001200137700001200149700001700161245012500178856006000303300001200363490000600375520161500381       2016                            d10aTreatment10aNeglected tropical diseases (NTDs)10aHIV10aCo-infection10aBuruli ulcer1 aKassi K1 aSerge E1 aJean-Marie K00aManagement of HIV infected patients with active Buruli ulcer in tropical regions, a new therapeutic challenge: a review.  uhttp://www.easycore.org/index.php/jdr/article/view/1547  a27–310 v13 a<p>Buruli ulcer (BU) is endemic in tropical and sub-tropical regions of sub-Saharan Africa, Asia, Australia, South America and the pacific mainly with high prevalence in West Africa. There is an increasing recognition of BU/HIV co-infection as an important challenge for treatment of Mycobacterium ulcerans disease, mainly in tropical regions. Because of its difficult management, BU/HIV co-infection due to IRIS or paradoxical reactions occurrence, and based on Tuberculosis/HIV co-infection management experience, at the initiative of WHO, some expert issued a preliminary guide to manage BU/HIV co-infection. We conducted a literature review based on current scientific articles and practice experiences to summarize information and guidance principles to make these following suggestions to health care practitioner: Before commencing BU treatment and before starting ART, all HIV/MU co-infected patients should be actively screened for tuberculosis. BU treatment should be commenced before commencing ART and provided for 8 weeks duration. And for the common sense, based on TB management experience HIV, TB and BU control programs should work together in a cooperative framework, mainly in tropical and subtropical regions where the prevalence of these 3 diseases seems high. As, HIV/BU co-infection is increasing in tropical regions, more study should be initiated to determine the cumulative effect of IRIS and paradoxical reactions in BU/HIV co-infected patients on ART and anti-mycobacterial agents, in order to set up recommendation as it was done in TB/HIV co-infection for proper management.</p>