Prevalence, Microbiological Characteristics, and Outcome of Disseminated Nontuberculous Mycobacterial Infection in People Living With HIV

Abstract The incidence of disseminated nontuberculous mycobacterial (NTM) infection among people living with HIV (PLHIV) has declined with the introduction of highly active antiretroviral therapy. However, disseminated NTM infection remains a severe infection with high mortality rates. This study aims to investigate the prevalence and clinical characteristics of disseminated NTM infections among PLHIV. A systematic literature search was conducted in PubMed, ScienceDirect, and Ovid SP from inception up until to January 31, 2024. Pool estimates were calculated using the random-effects generic inverse variance model with a 95% confidence interval (CI). All statistical analysis was conducted in R programming. Sixteen studies comprised 3480 patients diagnosed with disseminated NTM infection among PLHIV. The prevalence of disseminated NTM infection in PLHIV was 4% (95% CI, 1%–14%). The prevalence of disseminated NTM infection in PLHIV with positive NTM isolation was 29% (95% CI, 9%–63%). The most common NTM isolated was Mycobacterium avium complex (79.0%; 95% CI, 57.3%–91.4%). The overall mortality rate was 33% (95% CI, 20%–49%). The incidence of disseminated NTM infection was low among PLHIV. However, the mortality rate remains high, despite the introduction of highly active antiretroviral therapy.