Benson C, Kerns E, Sha B, Glick E, Harris A, Kessler H; International Conference on AIDS.

Int Conf AIDS. 1990 Jun 20-23; 6: 250 (abstract no. Th.B.514).

Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA

OBJECTIVE: To evaluate the incidence and natural history of respiratory tract (RT) and GI tract (GI-T) colonization with MAC in HIV+ patients and the relationship of colonization to development of disseminated MAC disease (D-MAC). METHODS: Review of microbiology, bronchoscopy, pathology, cytopathology, and patient records for all HIV+ patients from whom MAC was isolated from 12/88 to 12/89. Colonization was defined as isolation of MAC from RT and/or GI-T specimens in the absence of symptoms or signs of MAC disease or from patients with symptoms and/or signs which responded to treatment for other pathogens. D-MAC was defined as isolation of MAC from blood (BL) and/or bone marrow (BM) on at least one occasion. RESULTS: A total of 139 HIV+ patients had RT specimens, 86 had GI-T specimens, and 84 had BL/BM specimens sent for MAC culture from 12/88 to 12/89. Fifteen of 139 patients (11%) had MAC isolated from the RT, 17 of 86 patients (20%) from the GI-T, and 20 of 84 patients (24%) from BL/BM. Of the 15 with RT MAC isolates, 4 were excluded as no GI-T or BL/BM cultures were done; of the 17 with GI-T MAC isolates, 2 were excluded because they had diagnoses of D-MAC prior to the evaluation period. Of the 20 HIV+ patients with D-MAC, 13 of 19 had RT(4), GI-T(7), or both RT and GI-T(2) specimens positive for MAC. One was excluded as no RT or GI-T specimens were sent for MAC culture. Only 1 of these 13 had an isolate which preceded BL/BM dissemination; a RT isolate 3 months prior to D-MAC. Four patients had RT, 5 had GI-T, and 1 had RT and GI-T MAC isolates with no evidence of D-MAC during the observation period. CONCLUSION: D-MAC occurs frequently in the absence of prior detectable RT and GI-T colonization. MAC may be isolated from the RT and/or GI-T without dissemination. Whether or not D-MAC develops in such patients remains to be determined.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• Bone Marrow
• Digestive System
• Gastrointestinal Tract
• HIV Infections
• HIV Seropositivity
• Humans
• Incidence
• Mycobacterium avium Complex
• Mycobacterium avium-intracellulare Infection
• Respiratory System
• drug therapy
• therapy

Other ID:

• 10051490

UI: 102182098

From Meeting Abstracts