title: Environmental risk factors for acquisition of Mycobacterium avium complex in persons with human immunodeficiency virus infection.
abstract: A case-control study was done to determine risk factors for Mycobacterium avium complex (MAC) disease in persons infected with human immunodeficiency virus (HIV) with < 50 CD4+ cells/mm3. In univariate analysis, cases (n = 83) had lower CD4+ cell counts than controls (n = 177) (median, 10 vs. 17/mm3; P < .001) and were more likely to have consumed hard cheese (odds ratio [OR], 5.44; 95% confidence interval [CI], 1.61-18.4) but were less likely to have taken daily showers (OR, 0.55; 95% CI, 0.33-0.94). In multivariate analysis, CD4+ cell count < 25/mm3 (OR, 3.58; 95% CI, 1.71-7.49) and consumption of hard cheese (OR, 5.63; 95% CI, 1.58-20.1) remained associated with disease, while daily showering (OR, 0.58; 95% CI, 0.28-0.88) remained protective. Increased risk for MAC disease in persons with HIV infection and low CD4+ cell counts is not associated with exposure to water or a variety of other environmental sources but may be associated with consumption of hard cheese.
authors.affiliation: Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
authors.forename: C R
authors.initials: CR
authors.lastname: Horsburgh
authors.forename: D P
authors.initials: DP
authors.lastname: Chin
authors.forename: D M
authors.initials: DM
authors.lastname: Yajko
authors.forename: P C
authors.initials: PC
authors.lastname: Hopewell
authors.forename: P S
authors.initials: PS
authors.lastname: Nassos
authors.forename: E P
authors.initials: EP
authors.lastname: Elkin
authors.forename: W K
authors.initials: WK
authors.lastname: Hadley
authors.forename: E N
authors.initials: EN
authors.lastname: Stone
authors.forename: E M
authors.initials: EM
authors.lastname: Simon
authors.forename: P
authors.initials: P
authors.lastname: Gonzalez
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology; D001494:Baths; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D002611:Cheese; D005243:Feces / Q000382:microbiology; D005260:Female; D005516:Food Microbiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D014871:Water Microbiology