{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:32:22Z","timestamp":1791174742355,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T00:00:00Z","timestamp":1477612800000},"content-version":"vor","delay-in-days":1031,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003Buruli ulcer 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.<\/jats:p>\n               <jats:p>Methods. \u2003This was a retrospective study of data collected at the Akonolinga District Hospital, Cameroon, from January 1, 2002 to March 27, 2013. Human immunodeficiency virus prevalence among BU patients was compared with 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. Buruli ulcer time-to-healing was assessed in different CD4 count strata, and factors associated with BU main lesion size at baseline were ide.jpegied.<\/jats:p>\n               <jats:p>Results. \u2003Human immunodeficiency virus prevalence among BU patients was significantly higher than the regional estimated prevalence in each group (children, 4.00% vs 0.68% [P &amp;lt; .001]; men, 17.0% vs 4.7% [P &amp;lt; .001]; women, 36.0% vs 8.0% [P &amp;lt; .001]). Individuals who were HIV positive 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 (\u03b2-coefficient, \u22120.50; P = .015; 95% confidence interval [CI], \u22120.91\u20130.10). Buruli ulcer 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\u20133.98).<\/jats:p>\n               <jats:p>Conclusion. \u2003Patients who are HIV positive are at higher risk for BU. Human immunodeficiency virus-induced immunosuppression seems to have an impact on BU clinical presentation and disease evolution.<\/jats:p>","DOI":"10.1093\/ofid\/ofu021","type":"journal-article","created":{"date-parts":[[2014,4,27]],"date-time":"2014-04-27T00:21:33Z","timestamp":1398558093000},"source":"Crossref","is-referenced-by-count":42,"title":["Impact of Human Immunodeficiency Virus on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon"],"prefix":"10.1093","volume":"1","author":[{"given":"Vanessa","family":"Christinet","sequence":"first","affiliation":[{"name":"HIV Unit, University of Geneva Hospitals, Geneva, Switzerland"},{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Comte","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ciaffi","sequence":"additional","affiliation":[{"name":"HIV Unit, University of Geneva Hospitals, Geneva, Switzerland"},{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Odermatt","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, Basel, Switzerland"},{"name":"University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela","family":"Serafini","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick","family":"Antierens","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovic","family":"Rossel","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain-Bertrand","family":"Nomo","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Nkemenang","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akoa","family":"Tsoungui","sequence":"additional","affiliation":[{"name":"Akonolinga District Hospital, Akonolinga, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Delhumeau","sequence":"additional","affiliation":[{"name":"HIV Unit, University of Geneva Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Calmy","sequence":"additional","affiliation":[{"name":"HIV Unit, University of Geneva Hospitals, Geneva, Switzerland"},{"name":"M\u00e9decins Sans Fronti\u00e8res, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,5,21]]},"reference":[{"key":"2020081009363619600_OFU021C1","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.4049\/jimmunol.0902854","article-title":"Mycolactone suppresses T cell responsiveness by altering both early signaling and posttranslational events","volume":"184","author":"Boulkroun","year":"2010","journal-title":"J Immunol"},{"key":"2020081009363619600_OFU021C2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.clindermatol.2008.09.021","article-title":"Buruli ulcer","volume":"27","author":"Portaels","year":"2009","journal-title":"Clin 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