Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study.
Eun-Hwa LeeBumSik ChinYoung Keun KimJin Sae YooYoung-Hwa ChoiSubin KimKi Hyun LeeSe Ju LeeJinnam KimYae Jee BaekJung Ho KimJin Young AhnSu Jin JeongNam Su KuJoon Sup YeomJun Yong ChoiPublished in: PloS one (2022)
With the introduction of combination antiretroviral therapy (cART), the prevalence of human immunodeficiency virus (HIV)-associated nontuberculous mycobacteria (NTM) disease has declined. However, NTM diseases still occur in people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA). We analysed the clinical and microbiological features of NTM diseases in PLWHA in South Korea. PLWHA who were diagnosed with NTM diseases between January 2000 and March 2021 were retrospectively enrolled from five different hospitals in South Korea. Data on baseline demographics, HIV status, CD4+ T cell counts, viral load, past and current cART regimens, isolated NTM species, results of antimicrobial susceptibility tests, treatment regimens, and outcomes were collected by reviewing medical records. A total of 34 cases of NTM in PLWHA were included. Pulmonary and extrapulmonary NTM diseases accounted for 58.8% (n = 20) and 41.2% (n = 14), respectively. The lymph node was the most common site of extrapulmonary NTM disease (64.3%). The age at the time of NTM disease diagnosis was younger in the extrapulmonary NTM group than in the pulmonary NTM group (37.0 vs. 49.0 years). Mean CD4+ T cell counts at the time of NTM disease diagnosis was 186.6 cells/μL (range: 1-1394). Nine patients (26.5%) had fully suppressed viral loads at the time of NTM disease diagnosis. Mycobacterium avium complex (MAC) was the most common species found, followed by M. intracellulare and M. kansasii. MAC isolates were all susceptible to clarithromycin, but the rates of non-susceptibility to moxifloxacin, linezolid, ethambutol, and rifampin were 75%, 37.5%, 12.5%, and 12.5%, respectively. The average duration of treatment was 17 months and the mortality rate was 8.8%. NTM diseases may occur in PLWHA, even with completely suppressed viral loads. The identified clinical features of NTM diseases are essential for its clinical management in South Korea.
Keyphrases
- antiretroviral therapy
- human immunodeficiency virus
- hiv aids
- hiv infected
- hiv positive
- hepatitis c virus
- lymph node
- hiv infected patients
- end stage renal disease
- healthcare
- chronic kidney disease
- sars cov
- mycobacterium tuberculosis
- big data
- machine learning
- helicobacter pylori
- peritoneal dialysis
- adipose tissue
- metabolic syndrome
- rectal cancer
- early stage
- cell proliferation
- artificial intelligence
- electronic health record
- combination therapy
- signaling pathway
- cell cycle arrest
- south africa
- peripheral blood
- radiation therapy
- cardiovascular disease
- helicobacter pylori infection