The clinical management of non-tuberculous mycobacteria 2024
British HIV Association guidelines on the management of opportunistic infection in people living with HIV:
The clinical management of non-tuberculous mycobacteria 2024
A wide spectrum of non-tuberculous mycobacteria (NTM) has been reported as isolates from or causes of disease in people living with human immunodeficiency virus (HIV). The latter is typically in the context of very advanced immunosuppression and absence of virological suppression with combination antiretroviral therapy (ART), with individuals presenting with disseminated disease.
NTM are environmental organisms. Therefore it is important to determine, prior to treatment initiation, whether the organism is the cause of the disease process rather than a reflection of colonisation. With the exception of M. avium complex (MAC), there is limited evidence to guide the choice or duration of treatment and expert opinion should be sought from a clinician/team experienced in managing mycobacterial disease in the context of HIV. Also with the exception of MAC infection, most of the recommendations for the treatment of NTM have been extrapolated from trials of treatment for NTM pulmonary disease in individuals without HIV, although some evidence from early trials in populations with advanced HIV disease has been added to this guidance.
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Additional information
General methodology
Supporting people living with HIV and opportunistic infections
Consultation comments
Comments received by the BHIVA Secretariat during the public consultation process
Declaration of interests
Declaration of interests from writing group members
Non-technical summary
Please note: The non-technical summary is less detailed than the full guideline and if you are reading this because it is relevant to your own healthcare, please do discuss any concerns or questions with your healthcare professionals.
Writing group
Prof Mark Nelson (Chair), Dr Margherita Bracchi, Dr Ewan Hunter, Prof Edmund Ong, Prof Anton Pozniak, Dr Clare van Halsema
UK-CAB (community) members are involved in the writing and/or proofreading of each chapter, and where not listed as authors are the UK-CAB members of the Guidelines Subcommittee.
Peer review
The guidelines were peer reviewed by Prof Constance Benson, University of California San Diego, CA, USA, Dr Alec Bonington, North Manchester General Hospital, UK, and Prof Christine Katlama, Hospital Pitie Salpetriere and Sorbonne University, Paris, France.
Guideline updates and date of next review
The guidelines are scheduled for full review by 2029.