Characteristics of Isolated Pulmonary and Generalized Mycobacteriosis in HIV-Positive Patients

The objective: to analyze and compare laboratory parameters in isolated pulmonary and generalized mycobacteriosis in HIV-positive patients.

Subjects and Methods. 115 adult HIV-positive patients with mycobacteriosis were included in a retrospective study, they all underwent in-patient treatment in Infectious Diseases Department of National Medical Research Center of Phthisiopulmonology and Infectious Diseases from 2019 to 2022. All patients included in the study had mycobacteriosis caused by Mycobacterium avium.

Results. Of the 115 patients, 70 (60.9%) were diagnosed with generalized mycobacteriosis (GM), and 45 (39.1%) were diagnosed with isolated pulmonary mycobacteriosis (IPM). In GM, there were no patients with a CD4+ T count greater than 85 cells/μl, and 75% of them had the count below 29.0 cells/μl. In IPM, the maximum CD4+ T count was 684 cells/μl, and 75% of patients had this count above 54.5 cells/μl. In GM versus IPM, the median CD4+ count was 10 times lower (13 cells/μl versus 134 cells/μl), and the mean VL in patients who did not receive ART or received ART for less than 2 months was higher (4.76 versus 3.91 log10 HIV RNA copies/ml; p = 0.006).

In GM Group, the most frequent (77.2%) combination was the following: CD4+ 0-50 cells/μl with VL 100,000 copies/ml (in 48.6% of patients) and CD4+ 0-50 cells/μl with VL 1001-99,999 copies/ml (in 28.6% of patients). In IPM Group, the most frequent (48.9%) combination was the following: CD4+ >200 cells/μl with VL 1000 copies/ml and below (28.9%) and with CD4+ 101-200 cells/μl with VL 1000 copies/ml and below – in 20.0% of patients). With CD4+ >101 cells/μl, even a high VL (100,000 copies/ml and above) did not lead to generalization of mycobacteriosis.

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