Changes in incidence and risk factors of Mycobacterium avium complex infections in patients with AIDS in the era of new antiretroviral therapies.
The aim of the study presented here was to determine the incidence, risk factors and prognostic indicators of Mycobacterium avium complex (MAC) infection in HIV-infected subjects prior to and after the introduction of highly active antiretroviral therapy (HAART). In the HAART era, the incidence of MAC infection decreased significantly from 3.7 to 0.9 per 100 person-years. Using logistic regression analysis, a high acute physiology and chronic health evaluation (APACHE) III score, a low number of CD4+ cells/ mm3 and a high level of HIV viremia were found to be independent predictors of the risk to develop MAC disease; however, a high APACHE III score was the only prognostic indicator associated with an unfavourable outcome of a disseminated MAC infection. These results indicate that MAC infections, although considerably less frequent in the HAART era, are still responsible for cases of severe disease.
Tumbarello
M
M
Department of Infectious Diseases, Catholic University, Rome, Italy. tumbarello@rm.unicatt.it
Tacconelli
E
E
de Donati
K G
KG
Bertagnolio
S
S
Longo
B
B
Ardito
F
F
Fadda
G
G
Cauda
R
R
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019380:Anti-HIV Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000187:drug effects / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy* / Q000453:epidemiology*; D016017:Odds Ratio; D011336:Probability; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate
D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents