TY  - JOUR
A1  - Wetzstein, Nils
A1  - Geil, Ari
A1  - Kann, Gerrit
A1  - Lehn, Annette
A1  - Schüttfort, Gundolf
A1  - Kessel, Johanna
A1  - Bingold, Tobias Michael
A1  - Küpper-Tetze, Claus Philippe
A1  - Haberl, Annette
A1  - Graf, Christiana
A1  - Vehreschild, Maria J. G. T.
A1  - Stephan, Christoph
A1  - Hogardt, Michael
A1  - Wichelhaus, Thomas Alexander
A1  - Wolf, Timo
T1  - Disseminated disease due to non-tuberculous mycobacteria in HIV positive patients: a retrospective case control study
T2  - PLOS ONE
N2  - Introduction 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. Materials and methods 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. Results 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). Conclusion 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.
KW  - Nontuberculous mycobacteria
KW  - Opportunistic infections
KW  - Antiretroviral therapy
KW  - HIV
KW  - Mycobacteria
KW  - Protease inhibitor therapy
KW  - Mycobacterium avium complex
KW  - Respiratory infections
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62674
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-626748
SN  - 1932-6203
VL  - 16
IS  - 7, art. e0254607
SP  - 1
EP  - 13
PB  - PLOS
CY  - San Francisco, California, US
ER  -