Nontuberculous Mycobacteria in Human Immunodeficiency Virus
Bibliographic record
Abstract
Payam Tabarsi Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail: [email protected] Abstract Background: Nontuberculous mycobacteria (NTM) are among the most important opportunistic infections among human immunodeficiency virus (HIV)-positive patients. Immunocompromised populations, such as those with HIV/acquired immunodeficiency syndrome (HIV/AIDS), are at a higher risk of being infected with NTM than immunocompetent individuals. Discussion: In high-income countries, including the USA and Canada, disseminated Mycobacterium avium complex or Mycobacterium kansasii infection of the species NTM is the third most common OI, after Pneumocystis jirovecii pneumonia and esophageal Candida. Moreover, people living with HIV with NTM disease were associated with a long-term case–fatality rate (CFR), with overall CFR increasing from 15.7% at 1 year to 22.6% at 5 years. In low- and middle-income countries (LMICs), NTM infections are largely overlooked due to limitations in medical resources and technology, with the first case of NTM lung disease in Ecuador being diagnosed in 2017. There is also a significant delay in the diagnosis of NTM diseases, especially in rural areas, and a high risk of misdiagnosis of Mycobacterium tuberculosis infections, with a misdiagnosis rate of 92.81% and a maximum misdiagnosis time of 21 years. Conclusion: NTM infections are not a notifiable infectious disease in most countries, and these factors combine to make NTM infections uncommon in studies of OIs in patients with HIV/AIDS in LMICs. Disseminated NTM infections are typically seen in the setting of severe immunocompromised. In people with HIV, disseminated NTM infections occur when the CD4+ T-cell count is <50 cells/mm3. Here, we describe a case of abdominal Mycobaterium simiae in a 30-year-old HIV woman as a manifestation of immune reconstitution syndrome. Keywords: Higher risk, human immunodeficiency virus, immunocompromised, infectious disease, nontuberculous mycobacteria
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".