Havlik J, Horsburgh C, Barrett K, Diem L, Rimland D, Thompson S; American Society for Microbiology. General Meeting.
Abstr Gen Meet Am Soc Microbiol. 1992; 92: 170 (abstract no. U-29).
Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA.
To evaluate the natural history of MAC in the respiratory or gastrointestinal (GI) tract of persons with HIV infection, we prospectively evaluated HIV infected patients with CD4+ counts less than 200 cells/mm and initial negative MAC blood cultures. Every three months patients were screened with culture of sputum, rectal swab and blood for mycobacteria; other cultures were performed as clinically indicated. Sputum and rectal swabs were decontaminated with NALC-2% NaOH and plated on LJ and 7H11 media. Patients were interviewed and examined for signs/symptoms, including fever (> or = 38 degrees C), night sweats, weight loss (> 10% in 6 months), diarrhea, anemia (Hct < 6%), elevated alkaline phosphatase (> 3X normal), and hepatosplenomegaly. Sixty-six patients were followed for a median of 7 months (range 3 to 12 months), a total of 35.6 patient-years. Two patients (3%) developed positive blood cultures for MAC. One had MAC in sputum one month before dissemination but negative stool and sputum 2 months before dissemination; the second had negative stool and sputum 2 months before dissemination. One patient developed disseminated TB with negative stool and sputum one month before dissemination. All 3 patients had < 50 CD4+ cells and were symptomatic. We conclude that colonization of respiratory or GI tract with MAC is uncommon, even in persons with severely impaired immunity. The duration of colonization preceding dissemination of MAC may be brief; alternatively, culture of stool swabs may not be a sensitive method for detection of early MAC colonization.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- CD4-Positive T-Lymphocytes
- Digestive System
- Feces
- Follow-Up Studies
- Gastrointestinal Tract
- HIV Infections
- HIV Seropositivity
- Humans
- Longitudinal Studies
- Mass Screening
- Mycobacterium avium Complex
- Mycobacterium avium-intracellulare Infection
- Prospective Studies
- Sputum
- diagnosis
Other ID:
UI: 102202451
From Meeting Abstracts