Clinical and epidemiologic features of infection with Mycobacterium genavense. Swiss HIV Cohort Study.
OBJECTIVE
To characterize clinical and epidemiologic features of infections with Mycobacterium genavense.


METHODS
Case series and case-control studies. Patients with M genavense were compared with two control groups: CD4 controls were matched on the basis of CD4 counts, and Mycobacterium avium-intracellulare complex controls had disseminated infection with M avium-intracellulare complex.


RESULTS
Fifty-four patients with disseminated infections caused by M genavense were found, from Europe (37), North America (15), and Australia (two). All were infected with human immunodeficiency virus. The median CD4 count was 0.016 x 10(9)/L (16/mm3) (range, 0.001 to 0.082 x 10(9)/L). Eighty-seven percent had fever and weight loss, 44% had diarrhea, 43% had splenomegaly, 39% had hepatomegaly, and 72% had anemia. In Swiss university hospitals, M genavense was responsible for 12.8% of nontuberculous disseminated mycobacterial infections in patients with human immunodeficiency virus from 1990 to 1992. The median survival was 190 days after the first isolation of M genavense. Among the patients who had been treated with at least two antimycobacterial drugs for 1 month or more, median survival was 263 days (95% confidence interval, 144 to 382 days), compared with 81 days (95% confidence interval, 73 to 89 days) for those not treated (P = .0009). Survival in patients with M genavense was similar to the survival of M avium-intracellulare complex controls. However, patients with similar CD4 counts (CD4 controls) survived longer (median, 342 days; 95% confidence interval, 269 to 415 days; P < .0003).


CONCLUSIONS
Infection with M genavense may be responsible for more than 10% of disseminated nontuberculous mycobacterial infections in patients with human immunodeficiency virus infection. Its clinical presentation and response to treatment are similar to those of infection with M avium-intracellulare complex.
Pechère
M
M
Division of Infectious Diseases, Hôpital Cantonal Universitaire, Geneva, Switzerland.
Opravil
M
M
Wald
A
A
Chave
J P
JP
Bessesen
M
M
Sievers
A
A
Hein
R
R
von Overbeck
J
J
Clark
R A
RA
Tortoli
E
E
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000453:epidemiology; D009656:North America / Q000453:epidemiology; D015996:Survival Rate