Hantavirus Pulmonary Syndrome, French Guiana

gust 2003 that compared HIV prevalence in 426 patients with Buruli ulcer and 613 controls in southern Benin, HIV prevalence among patients with Buruli ulcer was higher (2.6%, 11/426) than among controls (0.3%, 2/613) (odds ratio 8.1) (8). However, none of these reported HIV-positive patients with Buruli ulcer were treated with rifampin/streptomycin and antiretroviral therapy (8). A study of 224 patients with Buruli ulcer in Benin that evaluated the WHO-recommended regimen of 8 weeks of treatment with rifampin/ streptomycin showed promising results (9). Chemotherapy alone was successful in achieving a cure rate of 47% of patients and was effective against ulcers <5 cm in diameter (9). However, HIV testing was not performed in this study. In Spain, an HIVpositive patient with aggressive, multifocal Buruli ulcer and osteomyelitis was cured by surgery, broad-spectrum antimicrobial drugs (not rifampin/ streptomycin), and antiretroviral drugs (10). Relapse was not reported in this study at 6-months follow-up. For control of Buruli ulcer in HIV-positive patients, patients should be treated with rifampin/streptomycin and antiretroviral therapy to stimulate their immunity. Our report emphasizes the urgent need to evaluate treatment of HIV-positive patients infected with Buruli ulcer with rifampin/streptomycin and antiretroviral drugs.