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M94A0224.TXT
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1994-10-08
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Document 0224
DOCN M94A0224
TI A comparative study of transfusion-acquired human immunodeficiency
virus-infected children with and without disseminated Mycobacterium
avium complex.
DT 9412
AU Gleason-Morgan D; Church JA; Ross LA; Division of Allergy-Clinical
Immunology, Childrens Hospital Los; Angeles 90027.
SO Pediatr Infect Dis J. 1994 Jun;13(6):484-8. Unique Identifier : AIDSLINE
MED/94359770
AB For identification of the features of disseminated Mycobacterium avium
complex (DMAC) in human immunodeficiency virus (HIV)-infected children,
a retrospective medical record review of 31 long-term survivors with
transfusion-acquired HIV was conducted. Nine patients developed DMAC
defined as positive isolation of M. avium complex from peripheral blood.
DMAC was diagnosed in patients 51 to 132 months of age (mean, 101). The
time from HIV-infecting transfusion to DMAC diagnosis ranged from 37 to
132 months (mean, 92) and survival from the time of DMAC diagnosis
ranged from 4 to 21 months (mean, 10). Selected laboratory and clinical
measures in DMAC-positive and DMAC-negative subjects were compared.
DMAC-positive patients had significantly lower CD4+ T cell counts and
higher HIV p24 antigen concentrations than DMAC-negative patients at
comparable times. Increased percentages of circulating leukocyte band
forms and increased aspartate aminotransferase values were seen more
often in DMAC-positive patients. Fever and abdominal pain were the only
clinical features seen more often in DMAC-positive than in DMAC-negative
patients. At the end of the study period overall survival of
DMAC-positive patients was less than that of DMAC-negative children, at
33% vs. 73%. DMAC occurs in profoundly immunocompromised children with
advanced HIV disease and significantly affects survival. The clinical
and laboratory features of DMAC are relatively nonspecific and a high
index of suspicion in patients with markedly reduced CD4+ T cells is
essential.
DE Adolescence AIDS-Related Opportunistic Infections/DIAGNOSIS/MORTALITY/
*PHYSIOPATHOLOGY Blood Transfusion/*ADVERSE EFFECTS Child Child,
Preschool Comparative Study Female Human HIV Core Protein
p24/IMMUNOLOGY HIV Infections/MORTALITY/PHYSIOPATHOLOGY/*TRANSMISSION
Leukocyte Count Male Mycobacterium avium Complex/ISOLATION & PURIF
Mycobacterium avium-intracellulare Infection/DIAGNOSIS/MORTALITY/
*PHYSIOPATHOLOGY Retrospective Studies Survival Rate T4
Lymphocytes/IMMUNOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).