Impact of HIV on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon

Hdl Handle:
http://hdl.handle.net/10144/318846
Title:
Impact of HIV on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon
Authors:
Christinet, Vanessa; Rossel, Ludovic; Serafini, Micaela; Delhumeau, Cecile; Odermatt, Peter; Ciaffi, Laura; Nomo, Alain-Bertrand; Nkemenang, Patrick; Antierens, Annick; Comte, Eric; Tsoungui, Akoa; Calmy, Alexandra
Journal:
Open Forum Infectious Diseases
Abstract:
Background: Buruli ulcer (BU) is the third most common mycobacterial disease after tuberculosis and leprosy and is particularly frequent in rural West and Central Africa. However, the impact of HIV infection on BU severity and prevalence remains unclear. Methods: This was a retrospective study of data collected at the Akonolinga district hospital, Cameroon, from 1 January 2002 to 27 March 2013. HIV prevalence among BU patients was compared to regional HIV prevalence. Baseline characteristics of BU patients were compared between HIV-negative and HIV-positive patients, and according to CD4 cell count strata in the latter group. BU time-to-healing was assessed in different CD4 count strata and factors associated with BU main lesion size at baseline were identified. Results: HIV prevalence among BU patients was significantly higher than the regional estimated prevalence in each group (children, 4.00% vs 0.68% [P < .001]; men, 17.0% vs 4.7% [P < .001]; women, 36.0% vs 8.0% [P < .001]). HIV-positive individuals had a more severe form of BU with an increased severity in those with a higher level of immunosuppression. Low CD4 cell count was significantly associated with a larger main lesion size (beta-coefficient, -0.50; P = .015; 95% confidence interval [CI], -0.91 – 0.10). BU time-to-healing was more than double in patients with a CD4 cell count below 500 cell/mm3 (hazard ratio, 2.39; P = .001, 95% CI, 1.44 - 3.98). Conclusion: HIV-positive patients are at higher risk for BU. HIV-induced immunosuppression appears to have an impact on BU clinical presentation and disease evolution.
Publisher:
Oxford University Press
Issue Date:
26-Apr-2014
URI:
http://hdl.handle.net/10144/318846
DOI:
10.1093/ofid/ofu021
Additional Links:
http://ofid.oxfordjournals.org/cgi/doi/10.1093/ofid/ofu021
Language:
en
ISSN:
2328-8957
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorChristinet, Vanessaen_GB
dc.contributor.authorRossel, Ludovicen_GB
dc.contributor.authorSerafini, Micaelaen_GB
dc.contributor.authorDelhumeau, Cecileen_GB
dc.contributor.authorOdermatt, Peteren_GB
dc.contributor.authorCiaffi, Lauraen_GB
dc.contributor.authorNomo, Alain-Bertranden_GB
dc.contributor.authorNkemenang, Patricken_GB
dc.contributor.authorAntierens, Annicken_GB
dc.contributor.authorComte, Ericen_GB
dc.contributor.authorTsoungui, Akoaen_GB
dc.contributor.authorCalmy, Alexandraen_GB
dc.date.accessioned2014-06-04T08:01:03Z-
dc.date.available2014-06-04T08:01:03Z-
dc.date.issued2014-04-26-
dc.identifier.citationImpact of HIV on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon 2014 Open Forum Infectious Diseasesen_GB
dc.identifier.issn2328-8957-
dc.identifier.doi10.1093/ofid/ofu021-
dc.identifier.urihttp://hdl.handle.net/10144/318846-
dc.description.abstractBackground: Buruli ulcer (BU) is the third most common mycobacterial disease after tuberculosis and leprosy and is particularly frequent in rural West and Central Africa. However, the impact of HIV infection on BU severity and prevalence remains unclear. Methods: This was a retrospective study of data collected at the Akonolinga district hospital, Cameroon, from 1 January 2002 to 27 March 2013. HIV prevalence among BU patients was compared to regional HIV prevalence. Baseline characteristics of BU patients were compared between HIV-negative and HIV-positive patients, and according to CD4 cell count strata in the latter group. BU time-to-healing was assessed in different CD4 count strata and factors associated with BU main lesion size at baseline were identified. Results: HIV prevalence among BU patients was significantly higher than the regional estimated prevalence in each group (children, 4.00% vs 0.68% [P < .001]; men, 17.0% vs 4.7% [P < .001]; women, 36.0% vs 8.0% [P < .001]). HIV-positive individuals had a more severe form of BU with an increased severity in those with a higher level of immunosuppression. Low CD4 cell count was significantly associated with a larger main lesion size (beta-coefficient, -0.50; P = .015; 95% confidence interval [CI], -0.91 – 0.10). BU time-to-healing was more than double in patients with a CD4 cell count below 500 cell/mm3 (hazard ratio, 2.39; P = .001, 95% CI, 1.44 - 3.98). Conclusion: HIV-positive patients are at higher risk for BU. HIV-induced immunosuppression appears to have an impact on BU clinical presentation and disease evolution.en_GB
dc.language.isoenen
dc.publisherOxford University Pressen_GB
dc.relation.urlhttp://ofid.oxfordjournals.org/cgi/doi/10.1093/ofid/ofu021en_GB
dc.rightsArchived with thanks to Open Forum Infectious Diseasesen_GB
dc.subjectBuruli Ulceren_GB
dc.subjectHIV/AIDSen_GB
dc.titleImpact of HIV on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroonen
dc.identifier.journalOpen Forum Infectious Diseasesen_GB
All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.