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Preliminary Observations of Veterans Without HIV Who Have Mycobacterium avium Complex Pulmonary Disease

Christen L Vagts1,2, Israel Rubinstein1,2

  • 1University of Illinois, Chicago.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
|April 21, 2022
PubMed
Abstract

Insights

Nontuberculous Mycobacterium pulmonary disease (NTM-PD) in veterans is often caused by Mycobacterium avium complex (MAC). Treatment completion rates were low, and characteristics varied, highlighting the need for further study in this population.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Veterans Health

Background:

  • Nontuberculous Mycobacterium-related pulmonary disease (NTM-PD) is frequently caused by Mycobacterium avium complex (MAC).
  • NTM-PD is increasingly diagnosed in the veteran population.
  • NTM-PD is associated with an elevated risk of mortality, with lack of treatment being a significant predictor.

Purpose of the Study:

  • To describe the clinical characteristics of veterans diagnosed with MAC-pulmonary disease (MAC-PD).
  • To analyze treatment practices and outcomes in veterans with MAC-PD.
  • To identify factors associated with MAC-PD in a veteran cohort.

Main Methods:

  • Retrospective review of electronic health records.
  • Inclusion of veterans without HIV diagnosed with sputum culture-positive MAC-PD.
  • Data collection from the Jesse Brown Veteran Affairs Medical Center in Chicago, Illinois, between 2008 and 2019.

Main Results:

  • Nineteen veterans were identified, predominantly male (89.5%), Black (73.6%), with a median age of 74.
  • Most veterans had underlying lung disease (84.2%) and were smokers (84.2%).
  • Respiratory symptoms were common (89.5%), and only 52.6% initiated guideline-directed therapy, with 50% completing it.

Conclusions:

  • Clinical, imaging, and treatment attributes of MAC-PD in Chicago metropolitan veterans without HIV are diverse.
  • MAC-PD in this cohort is associated with a high mortality rate.
  • Further research is needed to understand MAC-PD and its treatment in US veterans in urban, underresourced communities.

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