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Concomitant HIV and mycobacterial infection in Ireland, 1987-92

L M Mundy1, M M Lynch, B D Crowley

  • 1Department of Genitourinary Medicine, St James's Hospital, Dublin, Ireland.

International Journal of STD & AIDS
|November 1, 1994
PubMed

Insights

This study found an increasing trend of mycobacterial infections in HIV patients in Ireland, with a higher rate of non-tuberculous mycobacteria (MOTT) and poorer survival compared to Mycobacterium tuberculosis.

Area of Science:

  • Infectious Diseases
  • Public Health
  • HIV/AIDS Research

Background:

  • Human Immunodeficiency Virus (HIV) infection significantly increases susceptibility to opportunistic infections, including mycobacterial diseases.
  • Mycobacterial infections, both Mycobacterium tuberculosis (M.tb) and mycobacteria other than tuberculosis (MOTT), pose a substantial health burden in HIV-positive individuals.
  • Previous studies indicated a lower prevalence of MOTT in Ireland compared to other regions.

Purpose of the Study:

  • To analyze the trends and characteristics of concomitant HIV and mycobacterial infections in the Republic of Ireland over a six-year period.
  • To compare the incidence and outcomes of Mycobacterium tuberculosis versus MOTT infections in HIV-infected patients.
  • To identify risk factors and patient demographics associated with these infections.

Main Methods:

  • A retrospective review of culture-proven mycobacterial infections in HIV-infected patients was conducted.
  • Data collected included patient demographics, infection type (M.tb vs. MOTT), risk factors (e.g., homosexual activity, intravenous drug use, incarceration), treatment compliance, and patient survival.
  • Statistical analysis, including log-rank test, was used to compare survival rates.

Main Results:

  • A total of 42 mycobacterial infections were identified in 40 HIV-infected patients.
  • There was a significant increase in MOTT infections compared to historical data, with an overall 4-fold rise in detection rates between 1987 and 1992.
  • MOTT infections were more common in homosexual individuals, while M.tb predominated in intravenous drug users (IVDUs). Non-compliance led to tuberculosis relapse and drug resistance.
  • One-year survival rates were significantly lower for MOTT infections (36%) compared to M.tb infections (79%).

Conclusions:

  • The incidence of mycobacterial infections, particularly MOTT, is rising among HIV-infected individuals in Ireland.
  • Treatment compliance is critical for preventing tuberculosis relapse and the development of drug-resistant strains.
  • Mycobacterium tuberculosis infections have a better prognosis than MOTT infections in this patient population, highlighting the need for targeted management strategies.

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