Natural history of Mycobacterium avium complex lung disease in untreated patients with stable course

[摘要] Little is known about the long-term natural history of Mycobacterium avium complex lung disease (MAC-LD) in untreated patients with stable course.The aim of this study was to investigate the natural course of untreated stable MAC-LD; with a focus on factors associated with clinical deterioration; spontaneous sputum conversion and prognosis.Of 488 patients diagnosed with MAC-LD between 1998 and 2011; 305 patients (62.5%) showed progressive MAC-LD resulting in treatment initiation within 3xe2x80x85years of diagnosis and 115 patients (23.6%) exhibited stable MAC-LD for at least 3xe2x80x85years with a median follow-up duration of 5.6xe2x80x85years. Patients with stable MAC-LD were more likely to have higher body mass index and less systemic symptoms at initial diagnosis compared with patients with progressive MAC-LD; while positive sputum acid-fast bacilli smear; fibrocavitary type and more extensive disease in radiological findings were more associated with progressive MAC-LD. Of the untreated patients with stable MAC-LD; 51.6% underwent spontaneous sputum conversion; with younger age; higher body mass index and negative sputum acid-fast bacilli smear at initial diagnosis found to be predictors of this occurrence.Advanced age; fibrocavitary type and abnormal pulmonary function were negative prognostic factors for survival in patients with stable MAC-LD.

[学科分类] 呼吸医学