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Mycobacterium genavense is a challenging opportunistic pathogen to diagnose and manage in HIV patients. Persistent immune suppression or protracted immune reconstitution inflammatory syndrome can lead to complicated clinical courses. We describe three cases of Mycobacterium genavense in HIV patients representing the spectrum between disease burden and strength of immune response.

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Abstract Eight-day inpatient directly observed therapy confirmed nonadherence as the major cause of virologic failure for 9 (45%) of 20 highly treatment-experienced persons with human immunodeficiency virus, extensive antiretroviral drug resistance, and high self-reported adherence rates, preventing unnecessary regimen changes.