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Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study

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). W...

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Autores principales: Lee, Eun Hwa, Chin, BumSik, Kim, Young Keun, Yoo, Jin Sae, Choi, Young-Hwa, Kim, Subin, Lee, Ki Hyun, Lee, Se Ju, Kim, Jinnam, Baek, Yae Jee, Kim, Jung Ho, Ahn, Jin Young, Jeong, Su Jin, Ku, Nam Su, Yeom, Joon-Sup, Choi, Jun Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648836/
https://www.ncbi.nlm.nih.gov/pubmed/36355915
http://dx.doi.org/10.1371/journal.pone.0276484
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author Lee, Eun Hwa
Chin, BumSik
Kim, Young Keun
Yoo, Jin Sae
Choi, Young-Hwa
Kim, Subin
Lee, Ki Hyun
Lee, Se Ju
Kim, Jinnam
Baek, Yae Jee
Kim, Jung Ho
Ahn, Jin Young
Jeong, Su Jin
Ku, Nam Su
Yeom, Joon-Sup
Choi, Jun Yong
author_facet Lee, Eun Hwa
Chin, BumSik
Kim, Young Keun
Yoo, Jin Sae
Choi, Young-Hwa
Kim, Subin
Lee, Ki Hyun
Lee, Se Ju
Kim, Jinnam
Baek, Yae Jee
Kim, Jung Ho
Ahn, Jin Young
Jeong, Su Jin
Ku, Nam Su
Yeom, Joon-Sup
Choi, Jun Yong
author_sort Lee, Eun Hwa
collection PubMed
description 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.
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spelling pubmed-96488362022-11-15 Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study Lee, Eun Hwa Chin, BumSik Kim, Young Keun Yoo, Jin Sae Choi, Young-Hwa Kim, Subin Lee, Ki Hyun Lee, Se Ju Kim, Jinnam Baek, Yae Jee Kim, Jung Ho Ahn, Jin Young Jeong, Su Jin Ku, Nam Su Yeom, Joon-Sup Choi, Jun Yong PLoS One Research Article 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. Public Library of Science 2022-11-10 /pmc/articles/PMC9648836/ /pubmed/36355915 http://dx.doi.org/10.1371/journal.pone.0276484 Text en © 2022 Lee et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lee, Eun Hwa
Chin, BumSik
Kim, Young Keun
Yoo, Jin Sae
Choi, Young-Hwa
Kim, Subin
Lee, Ki Hyun
Lee, Se Ju
Kim, Jinnam
Baek, Yae Jee
Kim, Jung Ho
Ahn, Jin Young
Jeong, Su Jin
Ku, Nam Su
Yeom, Joon-Sup
Choi, Jun Yong
Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title_full Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title_fullStr Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title_full_unstemmed Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title_short Clinical characteristics of nontuberculous mycobacterial disease in people living with HIV/AIDS in South Korea: A multi-center, retrospective study
title_sort clinical characteristics of nontuberculous mycobacterial disease in people living with hiv/aids in south korea: a multi-center, retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648836/
https://www.ncbi.nlm.nih.gov/pubmed/36355915
http://dx.doi.org/10.1371/journal.pone.0276484
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