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Article: High recurrence rate supports need for secondary prophylaxis in non-HIV patients with disseminated mycobacterium avium complex infection: a multi-center observational study

TitleHigh recurrence rate supports need for secondary prophylaxis in non-HIV patients with disseminated mycobacterium avium complex infection: a multi-center observational study
Authors
KeywordsMycobacterium avium complex
Non-HIV immunosuppression
Primary prophylaxis
Secondary prophylaxis
Disseminated infection recurrence rate
Issue Date2016
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/
Citation
BMC Infectious Diseases, 2016, v. 16, p. 74 How to Cite?
Abstract© 2016 Sridhar et al.Background: Long-term outcomes in non-HIV immunocompromised patients with disseminated Mycobacterium avium complex (dMAC) infections are unknown and the need for post-treatment secondary prophylaxis against MAC is uncertain in this setting. The objective of this study was to determine the need of continuing secondary anti-MAC prophylaxis in non-HIV patients after completing treatment of the primary dMAC episode. Methods: We conducted a ten-year multi-center analysis of non-HIV immunosuppressed patients with dMAC infections in Hong Kong. Results: We observed sixteen patients with dMAC during the study period of which five (31 %) were non-HIV immunosuppressed patients. In the non-HIV immunosuppressed group, three patients completed a treatment course without secondary prophylaxis, one patient received azithromycin-based secondary prophylaxis and one patient was still receiving therapy for the first dMAC episode. All the three patients who completed treatment without being given secondary prophylaxis developed recurrent dMAC infection requiring retreatment. Conclusions: In view of the high rate of dMAC infection recurrence in non-HIV immunocompromised patients following treatment completion, our data support long-term anti-MAC suppression therapy after treatment of the first dMAC infection episode in immunocompromised non-HIV patients, as is recommended for patients with advanced HIV. Tests of cell mediated immune function need to be evaluated to guide prophylaxis discontinuation in non-HIV patients.
Persistent Identifierhttp://hdl.handle.net/10722/229313
ISSN
2015 Impact Factor: 2.69
2015 SCImago Journal Rankings: 1.510
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorSridhar, S-
dc.contributor.authorFung, KS-
dc.contributor.authorChan, JFW-
dc.contributor.authorLam, JY-
dc.contributor.authorYip, EK-
dc.contributor.authorHung, FNI-
dc.contributor.authorWu, AK-
dc.contributor.authorQue, TL-
dc.contributor.authorLau, SKP-
dc.contributor.authorWoo, PCY-
dc.date.accessioned2016-08-23T14:10:20Z-
dc.date.available2016-08-23T14:10:20Z-
dc.date.issued2016-
dc.identifier.citationBMC Infectious Diseases, 2016, v. 16, p. 74-
dc.identifier.issn1471-2334-
dc.identifier.urihttp://hdl.handle.net/10722/229313-
dc.description.abstract© 2016 Sridhar et al.Background: Long-term outcomes in non-HIV immunocompromised patients with disseminated Mycobacterium avium complex (dMAC) infections are unknown and the need for post-treatment secondary prophylaxis against MAC is uncertain in this setting. The objective of this study was to determine the need of continuing secondary anti-MAC prophylaxis in non-HIV patients after completing treatment of the primary dMAC episode. Methods: We conducted a ten-year multi-center analysis of non-HIV immunosuppressed patients with dMAC infections in Hong Kong. Results: We observed sixteen patients with dMAC during the study period of which five (31 %) were non-HIV immunosuppressed patients. In the non-HIV immunosuppressed group, three patients completed a treatment course without secondary prophylaxis, one patient received azithromycin-based secondary prophylaxis and one patient was still receiving therapy for the first dMAC episode. All the three patients who completed treatment without being given secondary prophylaxis developed recurrent dMAC infection requiring retreatment. Conclusions: In view of the high rate of dMAC infection recurrence in non-HIV immunocompromised patients following treatment completion, our data support long-term anti-MAC suppression therapy after treatment of the first dMAC infection episode in immunocompromised non-HIV patients, as is recommended for patients with advanced HIV. Tests of cell mediated immune function need to be evaluated to guide prophylaxis discontinuation in non-HIV patients.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/-
dc.relation.ispartofBMC Infectious Diseases-
dc.rightsBMC Infectious Diseases. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectMycobacterium avium complex-
dc.subjectNon-HIV immunosuppression-
dc.subjectPrimary prophylaxis-
dc.subjectSecondary prophylaxis-
dc.subjectDisseminated infection recurrence rate-
dc.titleHigh recurrence rate supports need for secondary prophylaxis in non-HIV patients with disseminated mycobacterium avium complex infection: a multi-center observational study-
dc.typeArticle-
dc.identifier.emailSridhar, S: sid8998@hku.hk-
dc.identifier.emailChan, JFW: jfwchan@hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.emailLau, SKP: skplau@hkucc.hku.hk-
dc.identifier.emailWoo, PCY: pcywoo@hkucc.hku.hk-
dc.identifier.authorityChan, JFW=rp01736-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.authorityLau, SKP=rp00486-
dc.identifier.authorityWoo, PCY=rp00430-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12879-016-1411-8-
dc.identifier.pmid26861696-
dc.identifier.pmcidPMC4748557-
dc.identifier.scopuseid_2-s2.0-84957575844-
dc.identifier.hkuros262233-
dc.identifier.volume16-
dc.identifier.spage74-
dc.identifier.epage74-
dc.publisher.placeUnited Kingdom-

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