Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia

Kimberly D. McCarthy, Kevin P. Cain, Kevin 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

33 Citations (Scopus)

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

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Nontuberculous Mycobacteria
Southeastern Asia
HIV
Lung Diseases
Tuberculosis
Cambodia
Vietnam

Keywords

  • Diagnosis
  • Immunocompromised
  • Mycobacterium species
  • Pathogenic

ASJC Scopus subject areas

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

Cite this

Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia. / McCarthy, Kimberly D.; Cain, Kevin P.; Winthrop, Kevin; Udomsantisuk, Nibondh; Lan, Nguyen T N; Sar, Borann; Kimerling, Michael E.; Kanara, Nong; Lynen, Lut; Monkongdee, Patama; Tasaneeyapan, Theerawit; Varma, Jay K.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 185, No. 9, 01.05.2012, p. 981-988.

Research output: Contribution to journalArticle

McCarthy, KD, Cain, KP, Winthrop, K, Udomsantisuk, N, Lan, NTN, Sar, B, Kimerling, ME, Kanara, N, Lynen, L, Monkongdee, P, Tasaneeyapan, T & Varma, JK 2012, 'Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia', American Journal of Respiratory and Critical Care Medicine, vol. 185, no. 9, pp. 981-988. https://doi.org/10.1164/rccm.201107-1327OC
McCarthy, Kimberly D. ; Cain, Kevin P. ; Winthrop, Kevin ; Udomsantisuk, Nibondh ; Lan, Nguyen T N ; Sar, Borann ; Kimerling, Michael E. ; Kanara, Nong ; Lynen, Lut ; Monkongdee, Patama ; Tasaneeyapan, Theerawit ; Varma, Jay K. / Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia. In: American Journal of Respiratory and Critical Care Medicine. 2012 ; Vol. 185, No. 9. pp. 981-988.
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AU - Sar, Borann

AU - Kimerling, Michael E.

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AU - Tasaneeyapan, Theerawit

AU - Varma, Jay K.

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N2 - 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.

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