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.
BT - Journal of Dermatological Research DO - 10.17554/j.issn.2413-8223.2016.01.2 LA - eng N2 -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.
PY - 2016 EP - 27–31 T2 - Journal of Dermatological Research TI - Management of HIV infected patients with active Buruli ulcer in tropical regions, a new therapeutic challenge: a review. UR - http://www.easycore.org/index.php/jdr/article/view/1547 VL - 1 ER -