[Nontuberculous mycobacteriosis; the present status and in the future. Infection with human immunodeficiency virus (HIV) and nontuberculous mycobacteriosis].
Disseminated Mycobacterium avium-intracellulare complex (DMAC) infection is a common complication of AIDS. The cumulative incidence is 40% in patient surviving 2 years after diagnosis of AIDS. AIDS patients with DMAC reduced life expectancy compared with those without. Antimycobacterial therapy with Clarithromycin (CAM) can significantly reduce bacteremia and improve symptoms, quality of life, and survival of patients with DMAC. Prophylactic therapy with Rifabutin, CAM and Azithromycin is effective and Synergic effect can be expected as Rifabutin and Azithromycin are administered together. But it is serious problem to get resistance to CAM when prophylactic therapy with CAM failed because we lose one of the most effective medicines against DMAC. It is recommended to start prophylactic therapy when CD4 Lymphocyte count falls below 50-75/microliters in patients who had opportunistic infection. In Japan, 32 cases of AIDS with NTM are reported. All of them are male and mean count of CD4+lymphocyte was 11/microliters. Twenty three out of 32 were MAC and 6 were M. kansasii. Cases of NTM bacteremia were 9 (69.2%) and cases of those without bacteremia were 4 (30.8%). Three out of 4 were cases of M. kansasii.
Mizutani
S
S
JATA, Fukujuji Hospital, Tokyo, Japan.
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy*; D017828:Rifabutin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D017828:Rifabutin; D017963:Azithromycin; D017291:Clarithromycin