title: Impact of highly active antiretroviral therapy on onset of Mycobacterium avium complex infection and cytomegalovirus disease in patients with AIDS.
abstract: OBJECTIVE
  To assess the impact of highly active antiretroviral therapy (HAART) on the onset of first disseminated Mycobacterium avium complex (MAC) infection and first cytomegalovirus (CMV) disease episode in HIV-infected at-risk patients.
  
  
  METHODS
  The incidence of the two infections occurring in at-risk patients was calculated for two periods (January 1995-June 1996 and July 1996-December 1997) using the database of the HIV-infected patients followed in the Infectious Diseases Department at the Pitié-Salpêtrière Hospital in Paris. HAART was progressively introduced in late June 1996 in France.
  
  
  RESULTS
  A total of 91 first disseminated MAC infections and 124 first CMV disease episodes were recorded. The incidence of first disseminated MAC infections fell from 13.4 per 100 person-years in the first 18-month period to 2.6 per 100 person-years in the second 18-month period. Similarly, the incidence of first CMV disease episodes fell from 20.9 to 3.5 per 100 person-years. Fourteen patients on HAART developed a first MAC infection, 12 (85.7%) within 2 months of starting HAART. Nineteen patients on HAART had a first CMV disease episode, 10 (52.6%) within 2 months of starting HAART.
  
  
  CONCLUSIONS
  HAART led to a five-fold decrease in the incidence of first disseminated MAC infections and a six-fold decrease in first CMV disease episodes, although patients remain vulnerable to both diseases for approximately 2 months after starting HAART.
authors: Département de Maladies Infectieuses et de Santé Publique, Hôpital de la Pitié-Salpêtrière, Paris, France. laurence.baril@aventis.com
authors: L
authors: L
authors: Baril
authors: M
authors: M
authors: Jouan
authors: R
authors: R
authors: Agher
authors: E
authors: E
authors: Cambau
authors: E
authors: E
authors: Caumes
authors: F
authors: F
authors: Bricaire
authors: C
authors: C
authors: Katlama
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000453:epidemiology* / Q000517:prevention & control