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

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.

Keywords

• |human immunodeficiency virus/acquired immune deficiency syndrome|disseminated nontuberculous mycobacteria|diagnosis|prognosis