A national retrospective case series on the management of disseminated NOn-tubeRculous mycobacTerial infectionin adults living with HIV: The NORTH study

Non-tuberculous mycobacteria (NTM) are bacteria found in the water and soil all around us. They can cause infection in people with weak immune systems. If we find NTM in blood, bone marrow, or lymph nodes, we call this disseminated NTM infection. People living with HIV can develop weak immune systems if they are not on HIV medication. HIV medication used nowadays is called modern antiretroviral therapy (ART). Modern ART keeps the HIV virus in check and helps people’s immune system get better quicker. Disseminated NTM infection was common in people living with HIV when ART did not exist or was less effective. Now, disseminated NTM infection is much less common. Studies that help us decide the best antibiotics for NTM and how long to treat are from many years ago. In these studies, ART was not as robust as it is now. These studies recommend treatment for NTM for many months. Medication for NTM can cause side effects and sometimes people struggle to take medication for this long. Doctors feel we need recent studies to help decide if shorter treatments are as safe now that we have modern ART. Our study will review cases of disseminated NTM in people living with HIV over the last 10 years across the UK. We will ask hospitals taking care of people living with HIV to take part. We will collect information on what medications patients receive, for how long, and how they do during and after treatment. By comparing how well people do depending on how long they received NTM treatment for, we will be able to find if shorter treatments are as safe. The results of this study will be shared with clinicians taking care of people living with HIV and community representatives.