Characteristics distinguishing disseminated Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterial (NTM) infection in HIV patients

Abstract

of results Of the 64 patients with confirmed mycobacterial infection, 31 had disseminated disease (MTB:21, NTM:10 [nine due to M. avium Complex]). Of these, 81% were black African, 45% male, and median age was 34 years. Patients with NTM had lower CD4 T-cell counts, more prior or concurrent AIDS-defining illnesses, and were more frequently taking HAART at the time of mycobacterial diagnosis. Six NTM infections and one MTB infection appeared to be unmasked by HAART. Clinical features at presentation were non-discriminatory. On imaging, patients with MTB more often had parenchymal lung disease, whilst thoracic and abdominal lymphadenopathy was common in both groups. None of the patients with NTM had AFB smear positive respiratory specimens. Whereas the yield of blood cultures was low in patients with MTB, bone marrow specimens were diagnostic in all patients. Mortality was 8% for MTB and 30% for NTM cases. Immune reconstitution disease was observed in 52% of MTB and 30% of NTM patients. (Table 1.)