Journal of Diagnostics Concepts & Practice >

2023 , Vol. 22 >Issue 04: 402 - 406

DOI: https://doi.org/10.16150/j.1671-2870.2023.04.012

Review articles

Current status and research progress of diagnosis and treatment of AIDS with disseminated non-tuberculous mycobacterial disease

Expand
  • 1. Shaoxing Central Hospital, China Medical University, Zhejiang Shaoxing 312000, China
    2. Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
    3. Shenzhen Third People's Hospital, the Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen 518000, China

Received date: 2022-04-01

  Online published: 2023-12-18

Fold

Abstract

Non-tuberculous mycobacteria (NTM), an opportunistic pathogen, generally rarely causes disease in immunocompetent populations unless host immune defenses are compromised. Acquired immune deficiency syndrome (AIDS) patients have a severe deficiency in immune function due to the destruction of CD4+ T lymphocytes by human immunodeficiency virus (HIV) in the body. When patients are infected with NTM, NTM is likely to colonize and eventually lead to disseminated NTM disease (DNTM). In recent years, the number of tuberculosis patients worldwide has been on a downward trend. However, the number of AIDS patients with NTM is on the rise with the AIDS epidemic, the increase in the number of immunosuppressed people, and the continuous advances in laboratory techniques for NTM testing. Compared with tuberculosis, our public health administration system has not incorporated NTM infection into the reporting system, and the previous clinical attention was insufficient, so the systematic studies are limited. The 5-year case fatality rate of AIDS patients with DNTM in some areas of China was as high as 26.7%. The disease is a great threat to patients' life and health, and consumes a lot of medical resources. At present, China still faces great challenges in differential diagnosis, treatment, and high fatality rate of NTM. Therefore, it is urgent to strengthen the clinical knowledge of DNTM and improve disease prevention and control as well as clinical response capabilities. In this study, the recent research progress of DNTM was reviewed to provide a reference and basis for clinicians to diagnose and treat AIDS with DNTM.

Key words： Human immunodeficiency virus/Acquired immune deficiency syndrome; Disseminated nontuberculous mycobacteria; Diagnosis; Prognosis

Cite this article

HU Jingjing, SHEN Yinzhong, LIU Li, LU Hongzhou . Current status and research progress of diagnosis and treatment of AIDS with disseminated non-tuberculous mycobacterial disease[J]. Journal of Diagnostics Concepts & Practice, 2023 , 22(04) : 402 -406 . DOI: 10.16150/j.1671-2870.2023.04.012

References

[1] JONES D, HAVLIR D V. Nontuberculous mycobacteria in the HIV infected patient[J]. Clin Chest Med, 2002, 23(3):665-674.
[2] HORSBURGH C R Jr, SELIK R M. The epidemiology of disseminated nontuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS)[J]. Am Rev Respir Dis, 1989, 139(1):4-7.
[3] FORDHAM VON R C, ARBEIT R D, TOSTESON A N, et al. The international epidemiology of disseminated Mycobacterium avium complex infection in AIDS. International MAC Study Group[J]. AIDS, 1996, 10(9):1025-1032.
[4] XU D, HAN C, WANG M S, et al. Increasing prevalence of non-tuberculous mycobacterial infection from 2004-2009 to 2012-2017: a laboratory-based[J]. J Infect, 2018, 76(4):422-424.
[5] RISTOLA M A, VON REYN C F, ARBEIT R D, et al. High rates of disseminated infection due to non-tuberculous mycobacteria among AIDS patients in Finland[J]. J Infect, 1999, 39(1):61-67.
[6] COLLINS L F, CLEMENT M E, STOUT J E. Incidence, long-term outcomes, and healthcare utilization of patients with human immunodeficiency virus/acquired immune deficiency syndrome and disseminated mycobacterium avium complex from 1992-2015[J]. Open Forum Infect Dis, 2017, 4(3):x120.
[7] TO K, CAO R, YEGIAZARYAN A, et al. General Overview of Nontuberculous Mycobacteria Opportunistic Pathogens: Mycobacterium avium and Mycobacterium abscessus[J]. J Clin Med, 2020, 9(8):2541.
[8] WU U I, HOLLAND S M. Host susceptibility to non-tuberculous mycobacterial infections[J]. Lancet Infect Dis, 2015, 15(8):968-980.
[9] NAIK E, LEBLANC S, TANG J, et al. The complexity of HLA class II (DRB1, DQB1, DM) associations with disseminated Mycobacterium avium complex infection among HIV-1-seropositive whites[J]. J Acquir Immune Defic Syndr, 2003, 33(2):140-145.
[10] SANGARI F J, GOODMAN J, PETROFSKY M, et al. Mycobacterium avium invades the intestinal mucosa prima-rily by interacting with enterocytes[J]. Infect Immun, 2001, 69(3):1515-1520.
[11] UCHIYA K, TAKAHASHI H, YAGI T, et al. Comparative genome analysis of Mycobacterium avium revealed genetic diversity in strains that cause pulmonary and disseminated disease[J]. PLoS One, 2013, 8(8):e71831.
[12] MCGARVEY J A, BERMUDEZ L E. Phenotypic and genomic analyses of the Mycobacterium avium complex reveal differences in gastrointestinal invasion and genomic composition[J]. Infect Immun, 2001, 69(12):7242-7249.
[13] JOHANSEN M D, HERRMANN J L, KREMER L. Non-tuberculous mycobacteria and the rise of Mycobacterium abscessus[J]. Nat Rev Microbiol, 2020, 18(7):392-407.
[14] GRIFFITH D E, AKSAMIT T, BROWN-ELLIOTT B A, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases[J]. Am J Respir Crit Care Med, 2007, 175(4):367-416.
[15] 中华医学会热带病与寄生虫学分会艾滋病学组. 人类免疫缺陷病毒/艾滋病患者合并非结核分枝杆菌感染诊治专家共识[J]. 传染病信息, 2019, 32(6):481-489.
[15] AIDS Professional Group, Society of Tropical Disease and Parasitology of Chinese Medical Association. Expert consensus on diagnosis and treatment of HIV/AIDS patients combined with nontuberculous mycobacteria infection[J]. Infect Dis Inform, 2019, 32(6):481-489.
[16] 中华医学会结核病学分会. 非结核分枝杆菌病诊断与治疗指南(2020年版)[J]. 中华结核和呼吸杂志, 2020, 43(11):918-946.
[16] Chinese Society for Tuberculosis, Chinese Medical Association. Guidelines for the diagnosis and treatment of non-tuberculous mycobacterial disease (2020 edition)[J]. Chin J Tuberc Respir Dis, 2020, 43(11):918-946.
[17] 缪青, 王美霞, 潘珏, 等. 基于CT综合评分系统的非结核分枝杆菌肺病的影像学特征及影响因素[J]. 中国临床医学, 2022, 29(3):409-414.
[17] MIAO Q, WANG MX, PAN Y, et al. Composite CT score-based assessment for comparative analysis of radiological feature and clinical factor in pulmonary non-tuberculous mycobacterial disease[J]. Chin J Clin Res, 2022, 29(3):409-414.
[18] KANADE S, NATARAJ G, SURYAWANSHI R, et al. Utility of MPT 64 antigen detection assay for rapid charac-terization of mycobacteria in a resource constrained setting[J]. Indian J Tuberc, 2012, 59(2):92-96.
[19] SEBASTIAN G, NAGARAJA SB, VISHWANATHA T, et al. Non-tuberculosis mycobacterium speciation using HPLC under Revised National TB Control Programme (RNTCP) in India[J]. J Appl Microbiol, 2018, 124(1):267-273.
[20] GENC G E, DEMIR M, YAMAN G, et al. Evaluation of MALDI-TOF MS for identification of nontuberculous mycobacteria isolated from clinical specimens in mycobacteria growth indicator tube medium[J]. New Microbiol, 2018, 41(3):214-219.
[21] SOMOSKOVI A, SALFINGER M. Nontuberculous mycobacteria in respiratory infections: advances in diagnosis and identification[J]. Clin Lab Med, 2014, 34(2):271-295.
[22] SHARMA S, LATAWA R, WANCHU A, et al. Differential diagnosis of disseminated Mycobacterium avium and Mycobacterium tuberculosis infection in HIV patients using duplex PCR[J]. Future Microbiol, 2021, 16(3):159-173.
[23] HUH H J, KIM SY, SHIM H J, et al. GenoType NTM-DR performance evaluation for identification of Mycobacterium avium complex and Mycobacterium abscessus and determination of clarithromycin and amikacin resistance[J]. J Clin Microbiol, 2019, 57(8):e00516-e00519.
[24] KAPLAN J E, BENSON C, HOLMES K K, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America[J]. MMWR Recomm Rep, 2009, 58(RR-4):1-207.
[25] CRILLY N P, AYEH S K, KARAKOUSIS P C. The new frontier of host-directed therapies for Mycobacterium avium complex[J]. Front Immunol, 2021, 11:623119.
[26] KILIN? G, SARIS A, OTTENHOFF T H M, et al. Host-directed therapy to combat mycobacterial infections[J]. Immunol Rev, 2021, 301(1):62-83.
[27] LIU L, SONG Z, XUN J, et al. PD-1 inhibitor for disseminated Mycobacterium avium infection in a person with HIV[J]. Open Forum Infect Dis, 2022, 10(1):ofac700.
[28] DEDRICK R M, GUERRERO-BUSTAMANTE C A, GARLENA R A, et al. Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus[J]. Nat Med, 2019, 25(5):730-733.
[29] DEDRICK R M, SMITH B E, CRISTINZIANO M, et al. Phage therapy of Mycobacterium infections: compassio-nate use of phages in 20 patients with drug-resistant Myco-bacterial disease[J]. Clin Infect Dis, 2023, 76(1):103-112.
[30] KOBAYASHI T, NISHIJIMA T, TERUYA K, et al. High Mortality of disseminated non-tuberculous Mycobacterial infection in HIV-infected patients in the antiretroviral therapy era[J]. PLoS One, 2016, 11(3):e0151682.
[31] BENSON C A, WILLIAMS P L, CURRIER J S, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome[J]. Clin Infect Dis, 2003, 37(9):1234-1243.
[32] HU J, GU L, SHAO Y, et al. Long-term case-fatality rate of nontuberculous mycobacterial disease in people living with HIV[J]. Infect Dis Poverty, 2022, 11(1):16.
[33] 吴跃, 邓西子, 胡凤玉, 等. AIDS合并播散性非结核分枝杆菌病的临床特征与死亡危险因素分析[J]. 中国艾滋病性病, 2017, 23(11):999-1001,1005.
[33] WU Y, DENG X Z, HU F Y, et al. Clinical characteristics and death risk factors of disseminated non-tuberculous mycobacterial infection in AIDS patients[J]. Chin J AIDS & STD, 2017, 23(11):999-1001,1005.
[34] LARSEN S E, REESE V A, PECOR T, et al. Subunit vaccine protects against a clinical isolate of Mycobacterium avium in wild type and immunocompromised mouse mo-dels[J]. Sci Rep, 2021, 11(1):9040.
Options
Outlines

/

〈 〉