Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia

Kimberly D. McCarthy, Kevin P. Cain, Kevin L. Winthrop, Nibondh Udomsantisuk, Nguyen T.N. Lan, Borann Sar, Michael E. Kimerling, Nong Kanara, Lut Lynen, Patama Monkongdee, Theerawit Tasaneeyapan, Jay K. Varma

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Rationale: Although nontuberculous mycobacteria (NTM) are widely documented as a cause of illness among HIV-infected people in the developed world, studies describing the prevalence of NTM disease among HIV-infected people inmost resource-limited settings are rare. Objectives: To evaluate the prevalence of mycobacterial disease in HIV-infected patients in Southeast Asia. Methods: We enrolled people with HIV from three countries in Southeast Asia and collected pulmonary and extrapulmonary specimens to evaluate the prevalence of mycobacterial disease. We adapted American Thoracic Society/Infectious Disease Society of America guidelines to classify patients into NTM pulmonary disease, NTM pulmonary disease suspects, NTM disseminated disease, and no NTM categories. Measurements and Main Results: In Cambodia, where solid media alone was used, NTM was rare. Of 1,060 patients enrolled in Thailand and Vietnam, where liquid culture was performed, 124 (12%) ad tuberculosis and 218(21%) had NTM. Of 218 patients with NTM, 66 (30%) were classified as NTM pulmonary disease suspects, 9 (4%) with NTM pulmonary disease, and 10 (5%) with NTM disseminated disease. The prevalence of NTM disease was 2% (19 of 1,060). Of 51 patients receiving antiretroviral therapy (ART), none had NTM disease compared with 19 (2%) of 1,009 not receiving ART. Conclusions: Although people with HIV frequently have sputum cultures positive for NTM, few meet a strict case definition for NTM disease. Consistent with previous studies, ART was associated with lower odds of having NTM disease. Further studies of NTM in HIV-infected individuals in tuberculosis-endemic countries are needed to develop and validate case definitions.

Original languageEnglish (US)
Pages (from-to)981-988
Number of pages8
JournalAmerican journal of respiratory and critical care medicine
Volume185
Issue number9
DOIs
StatePublished - May 1 2012

Keywords

  • Diagnosis
  • Immunocompromised
  • Mycobacterium species
  • Pathogenic

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia'. Together they form a unique fingerprint.

  • Cite this

    McCarthy, K. D., Cain, K. P., Winthrop, K. L., Udomsantisuk, N., Lan, N. T. N., Sar, B., Kimerling, M. E., Kanara, N., Lynen, L., Monkongdee, P., Tasaneeyapan, T., & Varma, J. K. (2012). Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia. American journal of respiratory and critical care medicine, 185(9), 981-988. https://doi.org/10.1164/rccm.201107-1327OC