ATYPICAL LYME BORRELIOSIS IN AN HIV-INFECTED MAN

We report the fourth case of Lyme borreliosis in a man infected with h uman immunodeficiency virus (HIV), The erythema chronicum migrans was persistent, overlapping with meningoradiculitis. Repeated immunofluore scence tests for Borrelia burgdorferi sensu late remained negative in both sera and cerebrospinal fluid (CSP), the enzyme-linked immunosorbe nt assay was weakly positive in serum and CSF and a Western blot was p ositive. The skin infiltrate was composed mostly of T lymphocytes with a CD4/CD8 ratio of 0.5. The course of the disease was favourable afte r treatment with intravenous ceftriaxone, Further studies are necessar y to evaluate whether HIV infection influences, as does syphilis, the course and response to treatment of Lyme borreliosis. Serological test s are insufficiently sensitive and the Western blot assay is necessary to confirm Lyme disease in HIV-positive patients.