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M94A0257.TXT
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1994-10-08
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Document 0257
DOCN M94A0257
TI The impact of Mycobacterium avium complex bacteremia and its treatment
on survival of AIDS patients--a prospective study.
DT 9412
AU Chin DP; Reingold AL; Stone EN; Vittinghoff E; Horsburgh CR Jr; Simon
EM; Yajko DM; Hadley WK; Ostroff SM; Hopewell PC; Medical Service, San
Francisco General Hospital Medical Center,; Georgia.
SO J Infect Dis. 1994 Sep;170(3):578-84. Unique Identifier : AIDSLINE
MED/94358491
AB It is currently recommended that patients with AIDS and Mycobacterium
avium complex (MAC) bacteremia receive antimycobacterial treatment.
However, no study has prospectively evaluated the impact of this
infection and its treatment on survival. This study prospectively
followed a cohort of 367 AIDS patients with < or = 50 CD4+ cells/microL
and found that MAC bacteremia was independently associated with an
increased risk of death (relative hazard [RH] = 1.8, 95% confidence
interval [CI] = 1.3-2.4, P < .001). Patients with MAC bacteremia who
were treated had a longer median survival than those who were not (263
vs. 139 days, P < .001); treatment was independently associated with a
lower risk of death (RH = 0.45, 95% CI = 0.23-0.89, P < .001). However,
23% of patients with bacteremia died within 28 days of that diagnosis;
few were treated. MAC bacteremia contributes to the death of patients
with AIDS, and treatment increases survival. However, many patients will
not survive long enough to receive treatment. These results underscore
the importance of early diagnosis and chemoprophylaxis for MAC
bacteremia.
DE Acquired Immunodeficiency Syndrome/MICROBIOLOGY/MORTALITY Adult
Antibiotics/*THERAPEUTIC USE Antibiotics, Combined/THERAPEUTIC USE
Antibiotics, Macrolide/THERAPEUTIC USE AIDS-Related Opportunistic
Infections/*DRUG THERAPY/*MORTALITY Bacteremia/*DRUG THERAPY/*MORTALITY
Comparative Study Demography Human Multivariate Analysis
Mycobacterium avium-intracellulare Infection/*DRUG THERAPY/ *MORTALITY
Proportional Hazards Models Prospective Studies Risk Factors Support,
U.S. Gov't, P.H.S. Survival Analysis Time Factors T4 Lymphocytes
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).