Clinical Manifestations and Implications of Coinfection with Mycobacterium kansasii and Human Immunodeficiency Virus Type 1

Abstract

We conducted a retrospective study to further elucidate the clinical presentations and prognosis of disease due to Mycobacterium kansasii in patients infected with human immunodeficiency virus (HIV). Forty-nine HIV-infected patients first had M. kansasii isolated at a mean CD4 cell count of 62/mm3 and at a mean interval of 17 months after the diagnosis of AIDS. Seventeen of the 49 patients had disseminated disease caused by M. kansasii. Twenty-nine patients had a positive acid-fast smear of sputum, and 35 were known to be cigarette smokers. At the time of initial isolation of M. kansasii, 13 patients had other concurrent pulmonary isolates and 15 had another mycobacterial species concurrently isolated (the Mycobacterium avium complex in 13 instances). Patients who received antimycobacterial treatment survived longer than those who did not. Only one of the 49 patients was definitively determined to be colonized with M. kansasii without disease; therefore, it appears that pulmonary isolates of M. kansasii in HIV-infected patients are almost always associated with disease. The increase in rates of M. kansasii disease among HIV-infected patients has paralleled the rise of AIDS in Louisiana. So far, this state has recorded more coinfections with M. kansasii and HIV than any other.

Lipomannan and Lipoarabinomannan from a Clinical Isolate of Mycobacterium kansasii

“…Lipoglycans were hydrolyzed in 4 M trifluoroacetic acid for 4 h at 100°C and reduced with NaBH 4 in 0.05 M NH 4 OH for 4 h. The reduction was stopped by dropwise addition of acetic acid until the pH reached 6.0, and borate salts were co-distilled by repetitive evaporation in dry methanol. Per-acetylation was performed in acetic anhydride at 100°C for 2 h, and the derivatives were analyzed by GC on a BPX70 12-m ϫ 0.22-mm inner diameter column (chrompack).…”

“…Linkage analysis of monosaccharides was carried out by two steps of per-methylation (29), followed by derivatization with acetyl groups with acetic anhydride. Oligosaccharides generated by either mild hydrolysis or acetolysis were reduced using NaBH 4 in 0.05 M NH 4 OH for 4 h and per-methylated prior analysis by GC/MS on a WCOT fused silica 30-m ϫ 0.25-mm inner diameter column (chrompack).…”

“…An increase in M. kansasii disease has been observed because the onset of the AIDS epidemic (3). In the United States, the rates of disseminated disease among the human immunodeficiency virus-infected subjects reach 138 per 100,000 (4). It has been postulated that the natural habitat of M. kansasii is water (5).…”

Comparative In Vitro Activities of Linezolid, Telithromycin, Clarithromycin, Levofloxacin, Moxifloxacin, and Four Conventional Antimycobacterial Drugs against Mycobacterium kansasii

“…M. kansasii produces a chronic, progressive, and cavitary lung disease similar to tuberculosis or produces disseminated infections, usually in patients infected by the human immunodeficiency virus (4,7,20,24,31).…”

Severe Lung Disease due to Mycobacterium kansasii: Report of a Case and Review of the Literature

“…Only interstitial infiltrates with military pattern appears to be most frequent in patients with tuberculosis [6]. Finally, the presence of pleural effusions in patients with pulmonary disease caused by Mycobacterium kansasii has been rarely described in different series [5,13,23].…”