Preliminary analysis of the clinical characteristics of Mycobacterium avium infection in AIDS patients

CHEN Yu; LI Xiangli; LEI Suyun; ZHANG Mi; ZHANG Nian; YANG Cuixian

doi:10.3969/j.issn.1007-8134.2024.01.005

Abstract：Objective To analyze the clinical characteristics of Mycobacterium avium infection in AIDS patients and compare them with non-tuberculous mycobacteria ( NTM ) infection in AIDS patients, so as to provide laboratory data support for the clinical diagnosis and treatment of Mycobacterium avium disease. Methods The clinical data of 43 patients with AIDS complicated with Mycobacterium avium and 15 cases of other types of NTM infection diagnosed in Yunnan Provincial Infectious Disease Hospital from April 2016 to June 2022 were retrospectively analyzed, including demographic characteristics, clinical symptoms, imaging features, laboratory test indicators, treatment regimens and prognosis. Results The main clinical symptoms of Mycobacterium avium infection were fever, cough and sputum, fatigue and decreased body weight ( 60.47％ ), while other types of NTM were mainly fever, cough and fatigue (86.67％). Both groups of patients were mainly characterized by linear, patchy, and nodular shadows with lymph node enlargement in the lungs, accounting for 51.16％ and 53.33％, respectively. There was no statistically significant difference in laboratory indicators among different groups of CD4+ T cell counts in the Mycobacterium avium infection group. However, there were statistically significant differences in white blood cell counts and IL-6 levels between the CD4+ T cell group with 101-200 cells/µL and the CD4+ T cell group with <50 cells/µL ( H=10.316, H=16.130; P <0.05 ). Compared with those with Mycobacterium avium infection, the overall laboratory indexes in the other NTM infection group were closer to the normal range, but there was no statistical difference between CD4+ T cell counts and laboratory indicators ( P >0.05 ). Among the 58 patients, 35 patients were discharged after treatment, 20 patients were still in serious condition after anti-Mycobacterium avium treatment but gave up treatment and were automatically discharged, and 3 patients died. There was no significant difference in prognosis between patients with Mycobacterium avium infection and other types of NTM infection ( P=0.890 ). Conclusion Combined with the demographic characteristics, CD4+ T level, chest imaging features and clinical symptoms of patients with AIDS coinfection with NTM, it can assist in the rapid identification and diagnosis of Mycobacterium avium disease, and provide data support for the clinical treatment and prognosis of patients.