Document Detail

Prophylaxis against Mycobacterium avium-intracellulare complex infections in human immunodeficiency virus-infected patients.
MedLine Citation:
PMID:  9039547     Owner:  NLM     Status:  MEDLINE    
Infection due to the Mycobacterium avium complex (MAC) accounts for the most frequent AIDS-related opportunistic infections, but MAC infection is usually not the first AIDS-defining event that a patient infected with HIV experiences. The incidence increases linearly over time, at a rate of 20 to 25% per year, after a patient's first AIDS-defining event, and the incidence increases exponentially as the CD4+ cell count approaches zero. There is evidence that MAC may eventually infect most if not all HIV-infected patients who do not die from another HIV-related event. Since MAC infection contributes substantially to the morbidity and mortality of AIDS patients, prophylaxis appears to be mandatory. Rifabutin was the first drug which was shown to be effective in preventing MAC infection, and, recently, prophylaxis with clarithromycin was also found to prevent the disease. The optimal approach to prophylaxis still needs to be defined. Since a large majority of MAC infections occur in patients with CD4+ cell counts below 50/microliter, recommendations regarding the prophylaxis of patients with a history of an AIDS-defining opportunistic event and a CD4+ cell count between 50 and 200/microliter can be individualized, depending for example on how well the patient seems to be responding to antiretroviral treatment. Prophylaxis against MAC should be provided for any HIV-infected patient with a CD4+ cell count less than 50/microliter.
S D Nightingale
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Infection     Volume:  25     ISSN:  0300-8126     ISO Abbreviation:  Infection     Publication Date:    1997 Jan-Feb
Date Detail:
Created Date:  1997-07-08     Completed Date:  1997-07-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0365307     Medline TA:  Infection     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  67-70     Citation Subset:  IM; X    
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MeSH Terms
AIDS-Related Opportunistic Infections / epidemiology,  physiopathology,  prevention & control*
Antibiotics, Antitubercular / therapeutic use
Mycobacterium avium-intracellulare Infection / complications,  epidemiology,  physiopathology,  prevention & control*
Randomized Controlled Trials as Topic
Rifabutin / therapeutic use
Reg. No./Substance:
0/Antibiotics, Antitubercular; 72559-06-9/Rifabutin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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