Patterns of Mycobacterium avium Culture and PCR Positivity in Immunodeficient HIV-infected Patients: Progression from Localized to Systemic Disease

Autor: K Roth, Helmut Albrecht, S Tschauder, S Rüsch-Gerdes, Johannes R. Bogner, A. Stoehr, Norbert H. Brockmeyer, T. Mertenskötter, M. Dietrich, Emminger C, R Baumgarten, O. Loch, W Brockhaus, H. Jablonowski, A Roth
Rok vydání: 1997
Předmět:
Zdroj: Scandinavian Journal of Infectious Diseases. 29:579-584
ISSN: 1651-1980
0036-5548
Popis: Our aim was to establish the frequency and the longitudinal pattern of MAC culture positivity in late stage HIV-infected patients. Two other aims were to analyse risk factors for progression from localized to systemic disease and the value of PCR diagnosis using blood specimens. A total of 107 patients were recruited to be followed for 32 weeks. Prior MAC treatment and CD4 > 100/microliters were exclusion criteria. A total of 56 patients showed M. avium in at least 1 culture. 10/37 patients with MAC detected by culture first in 'non-sterile' specimens (stool, sputum) and urine progressed to systemic disease as determined by positive blood culture. Risk factors associated with this progression were a high symptom score at baseline, lymphadenopathy, anaemia, and low platelets. PCR was less sensitive than culture in detection of M. avium in blood specimens: Only 7/29 patients with positive blood cultures had a positive PCR at the same time. We conclude that symptomatic patients with advanced HIV-infection have a high frequency of MAC detection. Progression from localized to systemic culture positivity is associated with risk factors. Early 'pre-emptive' therapy is discussed.
Databáze: OpenAIRE
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