To investigate the predisposing conditions leading to NTM respiratory infections in HIV seronegative subjects, we reviewed the data from all patients who attended our institution during the past 15 years. 115 HIV seronegative subjects with NTM respiratory infections were identified. Most were infected with M. xenopi (n=66, 57.4%) or M. avium (n=47, 40.9%). The most frequent conditions associated with NTM infection were chronic obstructive pulmonary disease (COPD, n=33, 28.7%), previous tuberculosis (n=23, 20.0%), or both (n=33, 28.7%). Altogether, an underlying chest disease was found in all but 5 patients (96%). COPD was significantly more frequent in subjects infected with M. xenopi (47/66, 71.2%) than in subjects infected with M. avium (18/47, 38.3%). During an average follow-up of 4.9 Â± 0.3 years (range 0-16), 39 patients (37%) died. Factors associated with a poor prognosis in univariate analysis were aging, male gender, smoking history, alcohol consumption, underlying COPD, and co-infection with Aspergillus spp. 71.8% of deaths were due to respiratory failure. In conclusion, respiratory infections with NTM in HIV seronegative patients are almost always associated to an underlying chest disease, which appears to be the main determinant of prognosis.
Full conference title:
The American Lung Association - American Thoracic Association Conference,1998