Treatment of Mycobacterium avium complex immune reconstitution disease in HIV-1-infected individuals.
Immune reconstitution disease caused by Mycobacterium avium complex (MAC) infection presenting shortly after the introduction of highly active antiretroviral therapy (HAART) has been reported with increasing frequency in persons with HIV-1 infection during the past several years. Several therapeutic modalities have been utilized for this entity, but the optimal means of treating MAC immune reconstitution disease remains unclear. We now describe a patient who underwent some of these therapies. We then review the therapeutic outcomes from the numerous case reports of this disorder. Finally, we propose recommendations and a clinical algorithm regarding the optimal means of treatment of MAC immune reconstitution disease during HIV-1 infection.
Desimone
Joseph A
JA
Division of Infectious Diseases, Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. joseph.desimone@jefferson.edu
Babinchak
Timothy J
TJ
Kaulback
Kris R
KR
Pomerantz
Roger J
RJ
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active; D002939:Ciprofloxacin / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D003663:Decision Trees; D003937:Diagnosis, Differential; D015497:HIV-1; D006801:Humans; D008297:Male; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D011859:Radiography
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D017291:Clarithromycin