title: Nontuberculous mycobacterial disease in patients with HIV in Southeast Asia.
abstract: BACKGROUND
  Although nontuberculous mycobacteria (NTM) are widely documented as a cause of illness among HIV-infected people in the developed world, studies describing the prevalence of NTM disease among HIV-infected people in most resource-limited settings are rare.
  
  
  OBJECTIVE
  To evaluate the prevalence of mycobacterial disease in HIV-infected patients in Southeast Asia.
  
  
  METHODS
  We enrolled people with HIV from three countries in Southeast Asia and collected pulmonary and extrapulmonary specimens to evaluate the prevalence of mycobacterial disease. We adapted American Thoracic Society/Infectious Disease Society of America guidelines to classify patients into NTM pulmonary disease, NTM pulmonary disease suspects, NTM disseminated disease, and no NTM categories.
  
  
  RESULTS
  In Cambodia, where solid media alone was used, NTM was rare. Of 1,060 patients enrolled in Thailand and Vietnam, where liquid culture was performed, 124 (12%) had tuberculosis and 218 (21%) had NTM. Of 218 patients with NTM, 66 (30%) were classified as NTM pulmonary disease suspects, 9 (4%) with NTM pulmonary disease, and 10 (5%) with NTM disseminated disease. The prevalence of NTM disease was 2% (19 of 1,060). Of 51 patients receiving antiretroviral therapy (ART), none had NTM disease compared with 19 (2%) of 1,009 not receiving ART.
  
  
  CONCLUSIONS
  Although people with HIV frequently have sputum cultures positive for NTM, few meet a strict case definition for NTM disease. Consistent with previous studies, ART was associated with lower odds of having NTM disease. Further studies of NTM in HIV-infected individuals in tuberculosis-endemic countries are needed to develop and validate case definitions.
authors.affiliation: U.S. Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. kmccarthy3@cdc.gov
authors.forename: Kimberly D
authors.initials: KD
authors.lastname: McCarthy
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Cain
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Winthrop
authors.forename: Nibondh
authors.initials: N
authors.lastname: Udomsantisuk
authors.forename: Nguyen T N
authors.initials: NT
authors.lastname: Lan
authors.forename: Borann
authors.initials: B
authors.lastname: Sar
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kimerling
authors.forename: Nong
authors.initials: N
authors.lastname: Kanara
authors.forename: Lut
authors.initials: L
authors.lastname: Lynen
authors.forename: Patama
authors.initials: P
authors.lastname: Monkongdee
authors.forename: Theerawit
authors.initials: T
authors.lastname: Tasaneeyapan
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002160:Cambodia / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D009170:Nontuberculous Mycobacteria; D015995:Prevalence; D013785:Thailand / Q000453:epidemiology; D014744:Vietnam / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents