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

Authors
 Eun Hwa Lee  ;  BumSik Chin  ;  Young Keun Kim  ;  Jin Sae Yoo  ;  Young-Hwa Choi  ;  Subin Kim  ;  Ki Hyun Lee  ;  Se Ju Lee  ;  Jinnam Kim  ;  Yae Jee Baek  ;  Jung Ho Kim  ;  Jin Young Ahn  ;  Su Jin Jeong  ;  Nam Su Ku  ;  Joon-Sup Yeom  ;  Jun Yong Choi 
Citation
 PLOS ONE, Vol.17(11) : e0276484, 2022-11 
Journal Title
PLOS ONE
Issue Date
2022-11
MeSH
Acquired Immunodeficiency Syndrome* ; HIV Infections* / complications ; HIV Infections* / drug therapy ; HIV Infections* / epidemiology ; Humans ; Mycobacterium Infections, Nontuberculous* / complications ; Mycobacterium Infections, Nontuberculous* / drug therapy ; Mycobacterium Infections, Nontuberculous* / epidemiology ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Retrospective Studies
Abstract
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.
Files in This Item:
T202300749.pdf Download
DOI
10.1371/journal.pone.0276484
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Subin(김수빈)
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Kim, Jin Nam(김진남)
Baek, Yae Jee(백예지)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Lee, Ki Hyun(이기현)
Lee, Se Ju(이세주)
Lee, Eun Hwa(이은화)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193183
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