Impact of disseminated Mycobacterium avium-complex infection on survival of HIV-infected patients.
OBJECTIVE
To determine the frequency of disseminated Mycobacterium avium-complex infections (MAC) and the impact of MAC disease on overall survival in patients with HIV disease and AIDS.


METHODS
Prospective study of HIV infected patients with a CD4 lymphocyte count < 150/microliter or patients with AIDS over a 7-year period. Blood cultures of all patients presenting symptoms and signs suggestive of disseminated MAC infection were grown. Only patients who deceased at our clinic (n = 427) were included in the final analysis in order to calculate MAC disease-free survival and overall survival after first CD4 lymphocyte count < 100/microliter.


RESULTS
101 out of 427 patients (24%) developed disseminated MAC disease: The median time between first CD4 lymphocyte count < 100/microliter and MAC disease was 441 days (range 16 to 1560). The actuarial risk of MAC disease for the entire patient population was 12%, 28%, and 42% after 1, 2, and 3 years, respectively. When comparing overall survival after first CD4 lymphocyte count < 100/microliter, there was no statistically significant difference between patients who subsequently developed disseminated MAC infection and those who did not.


CONCLUSIONS
MAC disease is a very frequent opportunistic infection in advanced AIDS, mostly in patients with less than 50 CD4 cells/microliter. In contrast to reports from the US, only 24% of our patients developed MAC disease. Survival time between patients with and without MAC infection did not differ.
Brodt
H R
HR
Zentrum der Inneren Medizin, Medizinische Klinik III/Infektiologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
Enzensberger
R
R
Kamps
B S
BS
Keul
H G
HG
Helm
E B
EB
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000401:mortality*; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D008297:Male; D015270:Mycobacterium avium-intracellulare Infection / Q000276:immunology / Q000401:mortality*; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate