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Epidemiological, clinical and therapeutic features of AIDS‐related Mycobacterium kansasii infection during the HIV pandemic: an 11‐year follow‐up study
Author(s) -
Manfredi R,
Nanetti A,
Valentini R,
Ferri M,
Morelli S,
Calza L
Publication year - 2004
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2004.00249.x
Subject(s) - medicine , pandemic , epidemiology , human immunodeficiency virus (hiv) , covid-19 , virology , intensive care medicine , disease , infectious disease (medical specialty)
Objectives Optimal diagnosis and timely treatment of atypical mycobacteriosis, and especially Mycobacterium kansasii disease, remain a serious challenge for clinicians engaged in the management of the immunocompromised host. Methods and Results From more than 2700 hospitalizations (over 1800 patients) attributable to HIV‐associated disorders over an 11‐year period, 12 patients were found to have a confirmed M. kansasii infection. This reflects the recent reduction in the frequency of this HIV‐related complication, which virtually disappeared after the introduction of potent antiretroviral combinations in 1996. In the early 1990s, the lack of effective antiretroviral regimens made frequent the association with AIDS, a mean CD4 lymphocyte count of nearly 20 cells/μL, and an extremely variable chest X‐ray features. The recent detection of a further case was attributable to late recognition of very advanced HIV disease, complicated by multiple opportunistic disorders. Conclusions Mycobacterium kansasii respiratory or disseminated infection continues to occur, and poses diagnostic problems in terms of late or missed identification as a result of slow culture and frequently concurrent opportunistic disease. Serious therapeutic difficulties also arise from the unpredictable in vitro antimicrobial susceptibility profile of these organisms, and from the need to start an effective combination therapy that does not interfere with other medications as soon as possible.