The spectrum of Mycobacterium kansasii disease associated with HIV-1 infected patients

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G T Valainis1, L M Cardona, D L Greer

  • 1Infectious Disease Section, Tulane University Medical Center, New Orleans, Louisiana.

Journal of Acquired Immune Deficiency Syndromes
|January 1, 1991
PubMed

Insights

Mycobacterium kansasii (MK) infections are increasing in HIV-1 patients in Louisiana. Dual infections rose significantly, leading to atypical radiographs and poor survival rates, often with varied treatment approaches.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Louisiana is an endemic area for Mycobacterium kansasii (MK).
  • Human immunodeficiency virus (HIV-1) infection is a known risk factor for disseminated MK infections.
  • An increasing incidence of coinfection was hypothesized.

Purpose of the Study:

  • To review clinical, microbiologic, and radiographic data of MK infections over a 60-month period.
  • To determine the prevalence and impact of HIV-1 coinfection in MK cases.
  • To analyze outcomes and treatment patterns in coinfected patients.

Main Methods:

  • Systematic review of patient data from two referral centers.
  • Analysis of clinical, microbiologic, and radiographic findings.
  • Statistical comparison between HIV-1 coinfected and non-HIV-1 patients.

Main Results:

  • MK was isolated from 72 patients; 31.9% were coinfected with HIV-1.
  • The rate of dual infection increased from 0% to 50% over the study period.
  • HIV-1 coinfected patients had higher rates of extrapulmonary MK (p = 0.003), atypical chest radiographs (interstitial infiltrates without cavitation), and mortality (90.9% within 12 months).

Conclusions:

  • HIV-1 coinfection significantly impacts the presentation and outcome of Mycobacterium kansasii infections.
  • Atypical radiographic findings and high mortality are characteristic of dual infections.
  • Treatment approaches varied considerably, despite known effective anti-mycobacterial agents.

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