       Document 0858
 DOCN  M9620858
 TI    Disseminated disease due to Mycobacterium avium complex in AIDS.
 DT    9602
 AU    Flegg PJ; Laing RB; Lee C; Harris G; Watt B; Leen CL; Brettle RP;
       Regional Infectious Diseases Unit, City Hospital, Edinburgh, UK.
 SO    QJM. 1995 Sep;88(9):617-26. Unique Identifier : AIDSLINE MED/96030957
 AB    We retrospectively analysed 46 cases of disseminated infection with
       Mycobacterium avium complex (MAC) within a cohort of 702 HIV-infected
       patients in Edinburgh. Clinical features were compared with case-matched
       controls (AIDS cases without disseminated MAC), and survival and
       progression times were controlled for confounding variables that
       influence survival. Disseminated MAC was diagnosed antemortem in 18% of
       AIDS patients, and was the AIDS-defining diagnosis in 6% of all AIDS
       cases. Concomitant colonization of respiratory and gastrointestinal
       tracts was common (61% and 48%, respectively). In 58% of cases, CD4+
       counts were < 10 cells/mm3 (median 6 cells/mm3). Weight loss, anaemia,
       leucopenia, and elevated liver transaminases and alkaline phosphatase
       were significantly more common among cases than controls. Therapy was
       given in 74%, and not tolerated in 32%. Following AIDS diagnosis,
       disseminated MAC incidence was 14% at one year, 25% at 2 years and 36%
       at 3 years. Median survival after disseminated MAC diagnosis was 6
       months, with shorter survival in untreated cases. However, overall
       survival from AIDS diagnosis was not significantly different between
       patients who did or did not develop disseminated MAC. Disseminated MAC
       contributes significantly to AIDS morbidity, and its incidence increases
       with prolonged AIDS survival. Although survival following diagnosis is
       short, the development of disseminated MAC in AIDS probably does not
       affect overall survival. In cohorts with a low incidence, an alternative
       to prophylaxis might be surveillance and early diagnosis.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  AIDS-Related
       Opportunistic Infections/*COMPLICATIONS/DRUG THERAPY/  MORTALITY
       Case-Control Studies  Disease Progression  Female  Human  Male
       Mycobacterium/CLASSIFICATION  Mycobacterium avium-intracellulare
       Infection/*COMPLICATIONS/DRUG  THERAPY/MORTALITY  Retrospective Studies
       Scotland/EPIDEMIOLOGY  Survival Rate  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

