Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study.
<h4>Introduction</h4>Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S. American guidelines have recommended antimycobacterial prophylaxis in patients with low CD4 cell counts, a practice that...
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oai:doaj.org-article:c001ed96f528475eafb5ce3654e1442e2021-12-02T20:15:24ZDisseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study.1932-620310.1371/journal.pone.0254607https://doaj.org/article/c001ed96f528475eafb5ce3654e1442e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254607https://doaj.org/toc/1932-6203<h4>Introduction</h4>Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S. American guidelines have recommended antimycobacterial prophylaxis in patients with low CD4 cell counts, a practice that has not been adopted in Europe. This study aimed at examining the impact of disseminated NTM disease on clinical outcome in German HIV patients with a severe immunodeficiency.<h4>Materials and methods</h4>In this retrospective case control study, HIV patients with disseminated NTM disease were identified by retrospective chart review and matched by their CD4 cell counts to HIV patients without NTM infection in a 1:1 alocation. Primary endpoints were mortality and time to first rehospitalisation. In addition, other opportunistic diseases, as well as antimycobacterial and antiretroviral treatments were examined.<h4>Results</h4>Between 2006 and 2016, we identified 37 HIV patients with disseminated NTM disease. Most of them were suffering from infections due to M. avium complex (n = 31, 77.5%). Time to event analysis showed a non-significant trend to higher mortality in patients with disseminated NTM disease (p = 0.24). Rehospitalisation took place significantly earlier in patients with disseminated NTM infections (median 40.5 days vs. 109 days, p<0.0001).<h4>Conclusion</h4>In this retrospective case control study, we could demonstrate that mortality is not significantly higher in HIV patients with disseminated NTM disease in the ART era, but that they require specialised medical attention in the first months following discharge.Nils WetzsteinAri GeilGerrit KannAnnette LehnGundolf SchüttfortJohanna KesselTobias M BingoldClaus P Küpper-TetzelAnnette HaberlChristiana GrafMaria J G T VehreschildChristoph StephanMichael HogardtThomas A WichelhausTimo WolfPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254607 (2021) |
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Medicine R Science Q Nils Wetzstein Ari Geil Gerrit Kann Annette Lehn Gundolf Schüttfort Johanna Kessel Tobias M Bingold Claus P Küpper-Tetzel Annette Haberl Christiana Graf Maria J G T Vehreschild Christoph Stephan Michael Hogardt Thomas A Wichelhaus Timo Wolf Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| description |
<h4>Introduction</h4>Disseminated infection due to non-tuberculous mycobacteria has been a major factor of mortality and comorbidity in HIV patients. Until 2018, U.S. American guidelines have recommended antimycobacterial prophylaxis in patients with low CD4 cell counts, a practice that has not been adopted in Europe. This study aimed at examining the impact of disseminated NTM disease on clinical outcome in German HIV patients with a severe immunodeficiency.<h4>Materials and methods</h4>In this retrospective case control study, HIV patients with disseminated NTM disease were identified by retrospective chart review and matched by their CD4 cell counts to HIV patients without NTM infection in a 1:1 alocation. Primary endpoints were mortality and time to first rehospitalisation. In addition, other opportunistic diseases, as well as antimycobacterial and antiretroviral treatments were examined.<h4>Results</h4>Between 2006 and 2016, we identified 37 HIV patients with disseminated NTM disease. Most of them were suffering from infections due to M. avium complex (n = 31, 77.5%). Time to event analysis showed a non-significant trend to higher mortality in patients with disseminated NTM disease (p = 0.24). Rehospitalisation took place significantly earlier in patients with disseminated NTM infections (median 40.5 days vs. 109 days, p<0.0001).<h4>Conclusion</h4>In this retrospective case control study, we could demonstrate that mortality is not significantly higher in HIV patients with disseminated NTM disease in the ART era, but that they require specialised medical attention in the first months following discharge. |
| format |
article |
| author |
Nils Wetzstein Ari Geil Gerrit Kann Annette Lehn Gundolf Schüttfort Johanna Kessel Tobias M Bingold Claus P Küpper-Tetzel Annette Haberl Christiana Graf Maria J G T Vehreschild Christoph Stephan Michael Hogardt Thomas A Wichelhaus Timo Wolf |
| author_facet |
Nils Wetzstein Ari Geil Gerrit Kann Annette Lehn Gundolf Schüttfort Johanna Kessel Tobias M Bingold Claus P Küpper-Tetzel Annette Haberl Christiana Graf Maria J G T Vehreschild Christoph Stephan Michael Hogardt Thomas A Wichelhaus Timo Wolf |
| author_sort |
Nils Wetzstein |
| title |
Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| title_short |
Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| title_full |
Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| title_fullStr |
Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| title_full_unstemmed |
Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: A retrospective case control study. |
| title_sort |
disseminated disease due to non-tuberculous mycobacteria in hiv positive patients: a retrospective case control study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/c001ed96f528475eafb5ce3654e1442e |
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