Prevalence of Pulmonary Non-Tuberculous Mycobacteria Among People with HIV: A Systematic Review
Aisara Najma Waleefa1, Deby Kusumaningrum2*
Abstract
Nontuberculous mycobacteria (NTM) can cause pulmonary disease in people with HIV, and its clinical picture closely resembles pulmonary tuberculosis (TB), so NTM is often diagnosed and treated as TB without bacteriological confirmation. This systematic review, reported according to PRISMA 2020, synthesized observational studies of culture-confirmed pulmonary NTM among people with HIV to determine the prevalence of NTM among people with HIV, the prevalence of HIV among confirmed NTM cases, the distribution of NTM species, and the reported clinical characteristics. Twelve studies were included from 678 records identified. Methodological quality was assessed with a modified Newcastle-Ottawa Scale, and findings were synthesized narratively because of substantial heterogeneity. Two studies reported a true HIV-stratified prevalence of pulmonary NTM (11.8% and 2.0%), while eight studies reported the prevalence of HIV among confirmed NTM cases, ranging from 9.8% to 78.0% (sample-size-weighted average 40.6%). Mycobacterium avium (35.7%) and M. kansasii (21.8%) were the most common species. Respiratory (mean 69.5%) and systemic (mean 56.0%) symptoms were the most frequently reported manifestations and closely resembled pulmonary TB. No study was rated as high risk of bias, although only three of twelve were rated low risk. Pulmonary NTM is a clinically significant differential diagnosis in people with HIV and presumptive TB, which supports routine bacteriological confirmation. The scarcity of studies reporting a true HIV-stratified denominator is a priority for future research.
Keywords
nontuberculous mycobacteria; HIV; pulmonary disease; prevalence; Mycobacterium avium complex; systematic review
Cite This Article
Waleefa, A. N., Kusumaningrum, D. (2026). Prevalence of Pulmonary Non-Tuberculous Mycobacteria Among People with HIV: A Systematic Review. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 5: Sep – Oct 2026, Pages 715-722. URL: https://www.ijscia.com/wp-content/uploads/2026/10/Volume7-Issue5-Sep-Oct-No.1092-715-722.pdf
Volume 7 | Issue 5: Sep – Oct 2026
