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M. avium Complex and Other Nontuberculous Mycobacteria and HIV

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Encyclopedia of AIDS

Mycobacterium avium Complex

Definition

Mycobacterium avium complex (MAC) comprises two closely related acid-fast bacteria, M. avium and M. intracellulare. The most common clinical presentation of disease due to these organisms in adults is infection of the respiratory tract, primarily seen in immunocompetent individuals with underlying chronic pulmonary disease, while disseminated infection is primarily a complication of advanced human immunodeficiency virus (HIV) infection. Although the incidence of disseminated MAC infection (dMAC) has declined significantly with the widespread use of potent combination antiretroviral therapy (ART), it still remains an important complication of advanced HIV infection.

Epidemiology

Mycobacterium aviumcomplex organisms are thought to have little virulence in the normal host, and prior to the onset of the HIV epidemic had mostly been recognized as a cause of localized pneumonia in persons with chronic pulmonary disease. Reports of dMAC infection were...

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References

  • Aberg JA, Williams PL, Liu T, et al. A study of discontinuation of maintenance therapy in human immunodeficiency virus-infected subjects with disseminated Mycobacterium avium complex: AIDS Clinical Trials Group 393 Study Team. J Infect Dis. 2003;187:1346.

    Article  Google Scholar 

  • Anderson JT, Petersen M, Jimenez-Solem E, et al. Clarithromycin in early pregnancy and the risk of miscarriage and malformation: a register based nationwide cohort study. PLoS One. 2013;8(1), e53327.

    Article  Google Scholar 

  • Benson CA. Treatment of disseminated disease due to the Mycobacterium avium complex in patients with AIDS. Clin Infect Dis. 1994a;18 Suppl 3:S237–42.

    Article  PubMed  Google Scholar 

  • Benson CA. Disease due to the Mycobacterium avium complex in patients with AIDS: epidemiology and clinical syndrome. Clin Infect Dis. 1994b;18 Suppl 3:S218–22.

    Article  PubMed  Google Scholar 

  • Benson CA, Williams PL, Cohn DL, et al. Clarithromycin or rifabutin alone or in combination for primary prophylaxis of Mycobacterium avium complex disease in patients with AIDS: a randomized, double-blind, placebo-controlled trial. J Infect Dis. 2000;181(4):1289–97.

    Article  CAS  PubMed  Google Scholar 

  • Benson CA, Williams PL, Currier JS, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome. Clin Infect Dis. 2003;37:1234–43.

    Article  CAS  PubMed  Google Scholar 

  • Bottger EC, Teske A, Kirschner P, et al. Disseminated “Mycobacterium genavense” infection in patients with AIDS. Lancet. 1992;340(8811):76–80.

    Article  CAS  PubMed  Google Scholar 

  • Chaisson RE, Benson CA, Dube MP, et al. Clarithromycin therapy for bacteremic Mycobacterium avium complex disease. A randomized, double-blind, dose-ranging study in patients with AIDS. AIDS Clinical Trials Group Protocol 157 Study Team. Ann Intern Med. 1994;121:905–11.

    Article  CAS  PubMed  Google Scholar 

  • Cohn DL, Fisher EJ, Peng GT, et al. A prospective randomized trial of four three-drug regimens in the treatment of disseminated Mycobacterium avium complex disease in AIDS patients: excess mortality associated with high-dose clarithromycin. Terry Beirn Community Programs Clinical Research on AIDS. Clin Infect Dis. 1999;29:125–33.

    Article  CAS  PubMed  Google Scholar 

  • Corti M, Palmero D. Mycobacterium avium complex infection in HIV/AIDS patients. Expert Rev Anti Infect Ther. 2008;6(3):351–63.

    Article  CAS  PubMed  Google Scholar 

  • Currier JS, Williams PL, Koletar SL, et al. Discontinuation of Mycobacterium avium complex prophylaxis in patients with antiretroviral therapy- induced increases in CD4+ cell count. A randomized, double-blind, placebo-controlled trial. AIDS Clinical Trials Group 362 Study Team. Ann Intern Med. 2000;133:493–503.

    Article  CAS  PubMed  Google Scholar 

  • Doggett JS, Strasfield L. Disseminated Mycobacterium genavense with pulmonary nodules in a kidney transplant recipient: case report and review of the literature. Transpl Infect Dis. 2011;13(1):38–43.

    Article  CAS  PubMed  Google Scholar 

  • Dunne M, Fessel J, Kumar P, et al. A randomized, double-blind trial comparing azithromycin and clarithromycin in the treatment of disseminated Mycobacterium avium infection in patients with human immunodeficiency virus. Clin Infect Dis. 2000;31:1245–52.

    Article  CAS  PubMed  Google Scholar 

  • El-Sadr WM, Burman WJ, Grant LB, et al. Discontinuation of prophylaxis for Mycobacterium avium complex disease in HIV-infected patients who have a response to antiretroviral therapy. Terry Beirn Community Programs for Clinical Research on AIDS. N Engl J Med. 2000;342(15):1085–92.

    Article  CAS  PubMed  Google Scholar 

  • Gordin FM, Horsburgh CR. Mycobacterium avium complex. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 2897–909.

    Google Scholar 

  • Gordin F, Masur H. Prophylaxis of Mycobacterium avium complex bacteremia in patients with AIDS. Clin Infect Dis. 1994;18 Suppl 3:S223–6.

    Article  PubMed  Google Scholar 

  • Griffith DE, Aksait T, Brown-Elliot BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367–416.

    Article  CAS  PubMed  Google Scholar 

  • Guthertz LS, Damsker B, Bottone EJ, et al. Mycobacterium avium and Mycobacterium intracellulare infections in patients with and without AIDS. J Infect Dis. 1989;160(6):1037–41.

    Article  CAS  PubMed  Google Scholar 

  • Han XY, Tarrand JJ, Infante R, et al. Clinical significance and epidemiologic analyses of Mycobacterium avium and Mycobacterium intracellulare among patients without AIDS. J Clin Microbiol. 2005;43(9):4407–12.

    Article  PubMed  PubMed Central  Google Scholar 

  • Havlir DV, Dube MP, Sattler FR, et al. Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both. California Collaborative Treatment Group. N Engl J Med. 1996;335:392–8.

    Article  CAS  PubMed  Google Scholar 

  • Horsburgh CR. Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991;324(19):1332–8.

    Article  PubMed  Google Scholar 

  • Horsburgh CR. The pathophysiology of disseminated Mycobacterium avium complex disease in AIDS. J Infect Dis. 1999;179(Supplement 3):S461–5.

    Article  PubMed  Google Scholar 

  • Karakousis PC, Moore RD, Chaisson RE. Mycobacterium avium complex in patients with HIV infection in the era of highly active antiretroviral therapy. Lancet Infect Dis. 2004;4:557–65.

    Article  PubMed  Google Scholar 

  • Kiehn TE, Hoefer H, Bottger EC, et al. Mycobacterium genavense infections in pet animals. J Clin Microbiol. 1996;34(7):1840–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kunin M, Knecht A, Holtzman EJ. Mycobacterium chelonae peritonitis in peritoneal dialysis. Literature review. Eur J Clin Microbiol Infect Dis. 2014;33(8):1267–71.

    Article  CAS  PubMed  Google Scholar 

  • Lange CG, Woolley IJ, Brodt RH. Disseminated Mycobacterium avium-intracellulare complex (MAC) infection in the era of effective antiretroviral therapy: is prophylaxis still indicated? Drugs. 2004;64(7):679–92.

    Article  CAS  PubMed  Google Scholar 

  • Marras TK, Daley CL. A systematic review of the clinical significance of pulmonary Mycobacterium kansasii isolates in HIV infection. JAIDS. 2004;36(4):883–9.

    PubMed  Google Scholar 

  • Mizoshita T, Tanida S, Mizushima T, et al. A rare case of infectious colitis with ulcers in the cecum caused by Mycobacterium Gordonae. Intern Med. 2011;50(21):2583–6.

    Article  PubMed  Google Scholar 

  • Nightingale SD, Cameron DW, Gordin FM, et al. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS. N Engl J Med. 1993;329(12):828–33.

    Article  CAS  PubMed  Google Scholar 

  • Phillips P, Bonner S, Gataric N, et al. Nontuberculous mycobacterial immune reconstitution syndrome in HIV-infected patients: spectrum of disease and long-term follow-up. Clin Infect Dis. 2005;41(10):1483–97.

    Article  PubMed  Google Scholar 

  • Poles MA, Dieterich DT, Schwartz ED, et al. Liver biopsy findings in 501 patients infected with human immunodeficiency virus (HIV). J Acquir Immune Defic Syndr Hum Retrovirol. 1996;11(2):170–7.

    Article  CAS  PubMed  Google Scholar 

  • Wallace RJ, Tanner D, Brennan PJ, et al. Clinical trial of clarithromycin for cutaneous (disseminated) infection due to Mycobacterium chelonae. Ann Intern Med. 1993;119(6):482–6.

    Article  PubMed  Google Scholar 

  • Ward TT, Rimland D, Kauffman C, et al. Randomized, open-label trial of azithromycin plus ethambutol vs. clarithromycin plus ethambutol as therapy for Mycobacterium avium complex bacteremia in patients with human immunodeficiency virus infection. Veterans Affairs HIV Research Consortium. Clin Infect Dis. 1998;27:1278–85.

    Article  CAS  PubMed  Google Scholar 

  • Weinberger M, Berg SL, Feuerstein IM, et al. Disseminated infection with Mycobacterium gordonae: report of a case and critical review of the literature. Clin Infect Dis. 1992;14(6):1229–39.

    Article  CAS  PubMed  Google Scholar 

  • Woods GL. Disease due to the Mycobacterium avium complex in patients infected with human immunodeficiency virus: diagnosis and susceptibility testing. Clin Infect Dis. 1994;18 Suppl 3:S227–32.

    Article  PubMed  Google Scholar 

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Correspondence to Jeffrey D. Jenks .

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Jenks, J.D., Benson, C.A. (2016). M. avium Complex and Other Nontuberculous Mycobacteria and HIV. In: Hope, T., Stevenson, M., Richman, D. (eds) Encyclopedia of AIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9610-6_411-1

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