{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:17:42Z","timestamp":1788452262549,"version":"build-2803163510"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Mycobacterium avium complex lung disease (MAC-LD) is clinically heterogeneous and carries diverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe predictors of clinical progression of MAC-LD in a state-wide cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled adults with MAC-LD from across Virginia, USA starting in 2021. Every 6 months we performed respiratory quality of life questionnaire, scored CT scans, and recorded respiratory mycobacterial cultures including MAC speciation. Outcomes were classified using NTM-NET consensus definitions, factors predicting clinical progression analyzed by Poisson regression, and hierarchical clustering on principal components derived from Factorial Analysis of Mixed Data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Of 105 participants the median follow-up was 917 days. Mean age was 69.8 years, 79 (75%) were women, and 70 (67%) had nodular bronchiectasis. M. intracellulare was the most common species, present in 48 (46%) participants at enrollment, followed by M. avium (29, 28%), and M. intracellulare subspecies chimaera (11, 10%). Only 2 (9%) of 22 evaluable participants met the NTM-NET definition of cure. In all participants after multivariable adjustment, older baseline age (incidence rate ratio 1.03 [1, 1.06], p\u2009=\u20090.04) and fibrocavitary CT scan pattern (2.57 [1.33, 4.96], p\u2009=\u20090.005), were associated with unfavorable 12-month clinical progression. Species type and species persistence contributed to characteristics of three distinct phenotypes of MAC-LD of varying severity and clinical progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The majority of participants were not assessable for MAC-LD treatment outcomes using strict NTM-NET definitions. Species informed phenotypes of MAC lung disease are prognostically useful and can inform routine management and trial design.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag276","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:34:47Z","timestamp":1788449687000},"source":"Crossref","is-referenced-by-count":0,"title":["Prospective outcomes of adults with speciated\n                    <i>Mycobacterium avium<\/i>\n                    complex lung disease, 2021-2026"],"prefix":"10.1093","author":[{"given":"Scott K","family":"Heysell","sequence":"first","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Becker","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakruti","family":"Rao","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Nguyen","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianna","family":"Lefcofrides","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Strawley","sequence":"additional","affiliation":[{"name":"University of Virginia School of Data Science,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Stroup","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girija","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Kleinot","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Scheurenbrand","sequence":"additional","affiliation":[{"name":"Clinical Microbiology Laboratory, University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Young","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Virginia Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasie","family":"Hearn","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Virginia Department of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra","family":"Williams","sequence":"additional","affiliation":[{"name":"Virginia Polytechnic and State University Department of Biological Sciences,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Joseph","family":"Falkinham","sequence":"additional","affiliation":[{"name":"Virginia Polytechnic and State University Department of Biological Sciences,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharvari","family":"Narendra","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Casta\u00f1eda-Barba","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hanley","sequence":"additional","affiliation":[{"name":"University of Virginia Department of Radiology and Medical Imaging,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Ropp","sequence":"additional","affiliation":[{"name":"University of Virginia Department of Radiology and Medical Imaging,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Mathers","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"},{"name":"Clinical Microbiology Laboratory, University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R","family":"Houpt","sequence":"additional","affiliation":[{"name":"University of Virginia Division of Infectious Diseases and International Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,3]]},"container-title":["Annals of the American Thoracic 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