| performance assessment of new multiplex probe assay for identification of mycobacteria. | a new dna probe assay (inno lipa mycobacteria; innogenetics, ghent, belgium) for the simultaneous identification, by means of reverse hybridization and line-probe technology, of mycobacterium tuberculosis complex, mycobacterium kansasii, mycobacterium xenopi, mycobacterium gordonae, the species of the mycobacterium avium complex (mac), mycobacterium scrofulaceum, and mycobacterium chelonae was evaluated on a panel of 238 strains including, besides representatives of all the taxa identifiable by ... | 2001 | 11230430 |
| cell-mediated immune response to tuberculosis antigens: comparison of skin testing and measurement of in vitro gamma interferon production in whole-blood culture. | although delayed-type hypersensitivity skin testing with tuberculin purified protein derivative (ppd) is the standard for tuberculosis screening, its variability suggests the need for a more sensitive, noninvasive test. an in vitro whole-blood assay has been proposed as an alternative. using health care worker volunteers, we confirmed the correlation between ppd skin test (ppd-st) results (positive, induration of >15 mm) and a standardized gamma interferon (ifn-gamma) assay, quantiferon-tb (q-if ... | 2001 | 11238218 |
| spectrum of aids-defining illnesses in australia, 1992 to 1998: influence of country/region of birth. | to examine the influence of country/region of birth on spectrum of aids-defining illness. | 2001 | 11242202 |
| azithromycin: indications for the future? | the global challenge of optimally treating bacterial infections is continuously evolving. azithromycin, the first azalide antibiotic, presents pharmacokinetics and pharmacodynamics that allow for a simple dosing regimen with minimal side effects. current azithromycin uses include a variety of community-acquired respiratory tract, skin and soft tissue, and sexually transmitted disease infections. azithromycin has also demonstrated substantial activity against atypical organisms such as mycobacter ... | 2000 | 11249533 |
| in vitro activity of a novel antimycobacterial compound, n-octanesulfonylacetamide, and its effects on lipid and mycolic acid synthesis. | beta-sulfonyl carboxamides have been proposed to serve as transition-state analogues of the beta-ketoacyl synthase reaction involved in fatty acid elongation. we tested the efficacy of n-octanesulfonylacetamide (osa) as an inhibitor of fatty acid and mycolic acid biosynthesis in mycobacteria. using the bactec radiometric growth system, we observed that osa inhibits the growth of several species of slow-growing mycobacteria, including mycobacterium tuberculosis (h37rv and clinical isolates), the ... | 2001 | 11257028 |
| induction of in vivo resistance to mycobacterium avium infection by intramuscular injection with dna encoding interleukin-18. | interferon-gamma (ifn-gamma) is closely associated with the generation of cell-mediated immunity and resistance to intracellular parasites. interleukin-18 (il-18) was known to strongly induce ifn-gamma production by t cells and natural killer (nk) cells. in order to determine whether injection with dna encoding il-18 can stimulate the resistance to mycobacterium avium complex (mac) infection, the mature il-18 cdna with kappa leader sequence was cloned under control of the cytomegalovirus (cmv) p ... | 2001 | 11260329 |
| phagocytosis and killing of mycobacterium avium complex by human neutrophils. | organisms belonging to the mycobacterium avium complex (mac) cause life-threatening bacteremia in immunocompromised patients. monocytes and macrophages are thought to be responsible for ingestion and killing of mac. however, it has been suggested that neutrophils may play a role in the early immune response to mac infection. here, neutrophils in autologous plasma were incubated (at 0 and 37 degrees c) with m. avium labeled with auramine o, a potent fluorochrome. neutrophil phagocytosis was measu ... | 2001 | 11261786 |
| novel mycobacterium related to mycobacterium triplex as a cause of cervical lymphadenitis. | the mycobacterium avium complex (mac) is an important cause of cervical lymphadenitis in children, and its incidence appears to be increasing in the united states and elsewhere. in areas where mycobacterium tuberculosis is not prevalent, m. avium causes the vast majority of cases of mycobacterial lymphadenitis, although several other nontuberculous mycobacterial species have been reported as etiologic agents. this report describes the case of a child with cervical lymphadenitis caused by a nontu ... | 2001 | 11283032 |
| the esp culture system for drug susceptibilities of mycobacterium avium complex. | to validate the non-radiometric, broth-based esp system for determining mycobacterium avium complex (mac) susceptibilities. | 2000 | 11284923 |
| effect of oestrogen on mycobacterium avium complex pulmonary infection in mice. | the purpose of the present study was to elucidate the role of oestrogen in the pathogenesis of mycobacterium avium complex (mac) pulmonary disease, which occurs most frequently in postmenopausal women. the study was carried out in a murine infectious model using ovariectomized dba/2 female mice. infection with mac was established by intratracheal administration of bacilli. in some experiments, ovariectomized mice were treated with exogenous 17 beta-estradiol (e2). the number of bacilli in the lu ... | 2001 | 11298130 |
| enhanced inhibition of lymphocyte activation by mycobacterium avium complex in human t lymphotrophic virus type i carriers. | we have previously reported that disseminated pulmonary mycobacterium avium complex (mac) infection is more common in human t lymphotrophic virus type i (htlv-i) carriers than in non-carriers. however, the reason for this remains unclear. it has been shown that glycopeptidelipid (gpl), one of the lipid components of the cell envelope of mac, is able to reduce the lymphocyte blastogenic response to mitogens. the purpose of this study was to clarify whether or not the inhibitory effect of gpl diff ... | 2001 | 11312409 |
| missense mutation of the interleukin-12 receptor beta1 chain-encoding gene is associated with impaired immunity against mycobacterium avium complex infection. | interleukin-12 (il-12) plays an important role in the production of interferon gamma (ifn-gamma) and is essential for protection against intracellular pathogens such as mycobacterium and salmonella. a 31-year-old man had disseminated mycobacterium avium complex (mac) infection. the production of ifn-gamma by peripheral blood mononuclear cells stimulated with phytohemagglutinin (pha-pbmcs) was found severely impaired (40.7 pg/ml compared with 833 +/- 289 pg/ml for the patient's and healthy subjec ... | 2001 | 11313259 |
| azithromycin-containing regimens for treatment of mycobacterium avium complex lung disease. | ninety-two patients were assessable in 3 consecutive, open, noncomparative, prospective, controlled, single-center trials of the use of multidrug regimens that contain azithromycin for treating pulmonary mycobacterium avium complex (mac) disease. azithromycin was provided at a dose of 300-600 mg per day with oral companion drugs administered daily (regimen a, 29 patients); 600 mg 3 times weekly (t.i.w.), with oral companion drugs administered daily (regimen b, 20 patients); and 600 mg (t.i.w.), ... | 2001 | 11340525 |
| [disseminated atypical mycobacteriosis in a patient with chronic myelogenous leukemia]. | a 61-year-old woman with a 6-year history of chronic myelogenous leukemia (cml) presented with recurrent fever in july 1996. bone marrow aspiration, biopsy and chromosome analysis showed that cml was in the chronic phase. bone marrow biopsy revealed nonspecific inflammatory lesions. chest x-ray and computed tomography examinations demonstrated interstitial pneumonia. cultures of gastric juice and bone marrow yielded colonies of mycobacterium avium complex (mac), and a diagnosis of disseminated a ... | 2001 | 11345784 |
| use of potassium tellurite for rapid-drug susceptibility testing of mycobacterium avium complex. | mycobacterium avium complex (mac) is a major cause of infection in immunocompromised patients. mac possesses an enzyme that reduces potassium tellurite in less than 3 days and results in formation of a black precipitate. the objective of this study was to determine whether reduction of potassium tellurite by mycobacteria can be used as a means of testing the susceptibility of mac to clarithromycin. | 2001 | 11352188 |
| the clinical profile of end-stage aids. | the purpose of this study was to describe the clinical profile of end-stage aids in patients 12 months before death. a cross-sectional examination of hiv-infected patients who attended a public hiv outpatient clinic between 1990 and 1996 and who died was conducted. the prevalence and first-time acquisition of aids-defining conditions 12 months before death were evaluated. the aids-defining conditions with the highest percentages of first-time acquisition in the last 12 months of life were progre ... | 1998 | 11361906 |
| nocardiasis in patients with hiv infection. | the frequency of nocardia infection in hiv-infected patients has increased during the past few years from 0.3% in 1985 to 1.8% in 1989. although it is not of great concern as an aids-associated infection, the nonspecific clinical presentation in these patients might be confused with other lung infections such as tuberculosis (tb). the mortality rate can be as high as 60%. the authors diagnosed three homosexual men with nocardiasis among 1060 hiv-infected patients (0.2%) in a tertiary care center ... | 1998 | 11362038 |
| advances in the diagnosis and treatment of mycobacterium avium complex (mac) disease. | | 1994 | 11362136 |
| management of late-stage aids grows more complex. | the question of what to do for patients with late-stage aids becomes more complicated as new research reinforces the value of early treatment and prophylaxis for hiv patients. decisions ranging from cost and quality of life to toxicity and multiple drug interactions all must be taken into account. pneumocystis carinii pneumonia (pcp) still is the most common adverse event in the last six months of life, with wasting syndrome being second, followed closely by mycobacterium avium complex (mac) and ... | 1995 | 11362247 |
| opportunistic infections studies update. | studies being conducted on opportunistic infections among people with hiv are presented in list form. the list includes new studies, those still in development, and those slated to begin in 1995. areas of interest include candidiasis, cryptosporidiosis/microsporidiosis, cytomegalovirus (cmv), mycobacterium avium complex (mac) infection, pneumocystis carinii pneumonia (pcp), toxoplasmosis, and tuberculosis (tb). enrollment information can be obtained by calling 1-(800)-trials-a (tdd 1- 800-448-04 ... | 1995 | 11362449 |
| rifabutin for mac questioned. | vanderbilt university researcher mark a. pierce remains doubtful about whether prevention is preferable to active surveillance and aggressive treatment of early infection in aids patients with mycobacterium avium complex (mac). problems of cost, compliance, drug toxicity, drug interactions, and long-term efficacy have limited the routine use of rifabutin. two recently reported mac prophylaxis trials have indicated the drug's effectiveness in preventing the opportunistic infection, but neither tr ... | 1995 | 11362571 |
| abbott files snda for mac prophylaxis. | clinical results suggest that clarithromycin may be effective in preventing the onset of disseminated mycobacterium avium complex (mac). among 667 patients treated with clarithromycin, the incidence of disseminated mac was reduced 69 percent by using the antibiotic prophylactically. mortality from all causes over the 2-year period of the study was reduced by 28 percent among those receiving clarithromycin compared to those receiving placebo. the prophylactic regimen was well tolerated with the o ... | 1995 | 11362606 |
| mycobacterium avium complex and hiv. | mycobacterium avium complex (mac) is an increasingly common and severe complication of hiv infection that is associated with shortened survival. the epidemiology, pathogenesis, clinical features, prevention guidelines, and treatment options for the disease are provided. statistics given show estimates of aids or arc patients developing mac infection by baseline cd4+ count, and a list of the body organs most commonly involved with dissemination of mac, as well as areas that may become infected. f ... | 1995 | 11362745 |
| another perspective on mac prophylaxis. interview by gordon nary. | mark pierce, assistant professor of medicine and director of infectious disease outpatient services at vanderbilt university medical center, provides his observations on some new directions in mycobacterium avium complex (mac) prophylaxis. the usphs/isda guidelines for the prevention of disseminated infection with mac in persons infected with hiv are included. pierce discusses why physicians often do not follow the u.s. public health service task force's original recommendations on prophylaxis a ... | 1995 | 11362746 |
| clarithromycin prophylaxis against disseminated mycobacterium avium complex in patients with aids. | the author presents results of a study concerning clarithromycin prophylaxis against disseminated mycobacterium avium complex (mac) in 57 adult patients with aids. forty patients received 500 mg of clarithromycin two times a day by mouth as prophylaxis against disseminated mac; seventeen patients received no medication. results show that none of the forty patients developed mac, while eight of the seventeen patients in the control group did. data suggest that clarithromycin is successful as a pr ... | 1995 | 11362747 |
| researchers find new drugs to fight mac. | studies have shown clarithromycin (biaxin) and rifabutin to be effective against mycobacterium avium complex (mac), and to improve survivability. abbott laboratories is seeking approval from the food and drug administration (fda) for clarithromycin use in preventing mac. marion merrell dow, the manufacturer of rifabutin, is planning a prophylaxis trial with a close cousin of the drug, rifapentine. rifapentine has a long half-life, and has the potential to lengthen intermittent treatment for tube ... | 1995 | 11362925 |
| mycobacterium avium complex disease. | current treatment and prophylaxis trends for mycobacterium avium complex (mac) are examined, and related issues and conflicts are provided. issues include how mac is acquired; its pathogenesis; its clinical manifestations, diagnosis, and treatment options; follow-up to treatment; treatment advances and future directions; issues about prophylaxis; and recent research reports. also included are discussions on rifabutin and the issues surrounding rifabutin prophylaxis, a review of resistance and th ... | 1995 | 11363006 |
| fda approves biaxin for mac prophylaxis. food and drug administration. | in 1995, the food and drug administration (fda) extended the label use of biaxin (clarithromycin) to include prophylaxis against disseminated mycobacterium avium complex (mac). clinical trials demonstrated that clarithromycin decreased the risk of developing disseminated mac disease in patients with advanced aids. a statistically significant survival benefit was also observed. taste perversion was the only common adverse effect among treated patients. the fda is considering another supplemental ... | 1995 | 11363096 |
| icaac: what else is new? | three hiv-related topics were discussed at the 1995 interscience conference on antimicrobial agents and chemotherapy. 1) protease inhibitors given in high doses are able to delay resistance, even when given as monotherapy. combination therapies are more successful than monotherapies, and triple combinations are more effective than double combinations. 2) a cytomegalovirus (cmv) vaccine was well-tolerated and effective in healthy cmv-immune adults. a phase iii clinical trial found valaciclovir, a ... | 1996 | 11363114 |
| early intervention and prevention options. | in july 1993, the united states public health service and the infectious disease society of america gave a set of recommendations for early intervention and prevention of opportunistic infections in hiv-positive people. these guidelines follow cd4 counts. according to the guidelines, cd4 counts above 500 should be monitored every 4 to 6 months and screenings for tuberculosis, sexually transmitted diseases, and other diseases should also be done. at a cd4 count of 75, a prophylaxis of rifabutin a ... | 1996 | 11363117 |
| australia reports on aids: nef deletions, live vaccines, chinese travelers. | australian research shows that individuals who share hiv nef deletions and adjacent sequences in the long terminal repeat (ltr) segment of the viral genome may indicate a weakening of the virus. a cluster of long-term survivors who share this enfeebled virus has contributed to the attenuated hiv vaccine debate. the debate was discussed at the seventh annual australian conference for hiv medicine. the story began when a researcher discovered a relationship between a gay male blood donor and five ... | 1996 | 11363347 |
| clarithromycin for mac prevention offers additional benefits. | the use of clarithromycin in preventing mycobacterium avium complex (mac) may also prevent a number of other opportunistic infections in aids patients. a large multinational study showed a reduction in pneumocystis carinii pneumonia (pcp), community-acquired pneumonia (cap), and giardiasis, an intestinal disorder. the study involved participants with cd4 counts below 100. | 1996 | 11363431 |
| hold the big mac. | the retrovirus conference provided information on two studies that examine the prevention of mycobacterium avium complex (mac). people with an active infection run fevers, lose weight, and have no appetite. rifabutin is currently the only drug with food and drug administration (fda) approval for the prevention of mac. it was found to be most effective in combination with azithromycin, but because the two drugs are chemically similar, resistance to both is a threat. thirty percent of the people t ... | 1996 | 11363450 |
| progress report: prophylaxis and therapy for mac. | study efforts are showing progress in the prevention and therapy of mycobacterium avium complex (mac) infection. a review of recent study developments highlights clinical findings on prophylactic use of rifabutin, clarithromycin, and azithromycin, used both as monotherapies and as combination therapies. three tables highlight study results from mac prophylaxis studies, mac treatment studies, and candidate regimens for mac prophylaxis in aids. treatment of disseminated mac is also addressed. the ... | 1996 | 11363599 |
| missed tb in aids unit leads to tighter isolation. | the san francisco general hospital recently tightened its tuberculosis (tb) policies for isolating hiv-positive patients after learning that active tb patients had been admitted without respiratory protection. the new policy resulted from what was initially believed to be a tb outbreak on the aids unit. however, an investigation concluded that the patients were infected outside the hospital. the hospital now automatically screens patients for tb when they are admitted to the aids ward. hiv-posit ... | 1996 | 11363656 |
| old drug approved for mac prevention. | the food and drug administration (fda) approved the broad-spectrum antibiotic azithromycin for prevention of mycobacterium avium complex (mac) in people with advanced hiv disease. the treatment offers flexibility in that it can be taken once a week. clinical trials show that 1200 mg of azithromycin taken weekly reduced the risk of developing mac bacteria in the bloodstream. in a large double-blind study, the drug was more effective than rifabutin in preventing mac. a combination of azithromycin ... | 1996 | 11363659 |
| mac prophylaxis revisited. | mycobacterium avium complex (mac) infection occurs in 18 to 40 percent of people with aids, and most commonly in those with cd4 counts under 50. mac is a difficult infection to diagnose, as its symptoms mimic many other infections and tumors. mac infections can occur in the respiratory system or gastrointestinal tract, and the infection may spread through the bloodstream. clinical trials for mac prophylaxis include clarithromycin, rifabutin, or a combination of both. the individual drugs and the ... | 1996 | 11363706 |
| antivirals key to mac prevention regimen. | prophylaxis for mycobacterium avium complex (mac) should be considered standard treatment for all patients with advanced hiv disease. mac is the most common bacterial infection that affects aids patients. there are three effective agents that significantly reduce the risk of mac--rifabutin, clarithromycin, and azithromycin. mac prophylaxis is cost-effective, improves the quality of a patient's life, and improves overall survival by 25 to 32 percent. | 1996 | 11363722 |
| high-dose clarithromycin should be avoided. | high dosages of clarithromycin used to prevent mycobacterium avium complex (mac) in aids patients unexpectedly increased their risk of death. health officials are alerting clinicians to lower the prescribed doses. the new recommended dose is 500 mg. patients who took 1,000 mg twice a day experienced lower survival rates in the cpcra 009 clinical trial. the results were surprising and counterintuitive, and underscore the importance of having clinical endpoints in a trial rather than just dependin ... | 1996 | 11363723 |
| or is it the host, sir? | scientists at the ninth international symposium on infections in the immunocompromised host offered evidence that the rate of hiv disease progression may be determined by how vigorously host defenses are mobilized in the first weeks of infection. others report on the use of thalidomide or il-10 for curtailing or suppressing tumor necrosis factor alpha in coincident hiv and tuberculosis patients. the success of shoring up weakened host defenses against the onslaught of opportunistic pathogens, su ... | 1996 | 11363895 |
| opportunistic infections update. | an update is presented on some of the treatment developments for opportunistic infections (ois) associated with hiv infection. treatments discussed include clarithromycin and clofazimine for treatment of mycobacterium avium complex (mac), azithromycin for prevention of mac, fluconazole for prevention of fungal infections, msl109 for treatment of cytomegalovirus retinitis, and two new approaches for the treatment of kaposi's sarcoma. azithromycin's positive role in preventing pcp provides evidenc ... | 1996 | 11363899 |
| opportunistic infections: the growing challenge. | a great deal of attention at the xi international conference on aids was focused on new approaches to managing and preventing aids-related opportunistic infections (ois). aside from a similar prevalence of pneumocystis carinii pneumonia (pcp) in developed countries, a different spectrum of ois is seen in less developed areas, such as latin america, where many endemic diseases are included among ois. candidiasis has been the most common fungal pathogen, but a broader spectrum of mycoses is being ... | 1996 | 11363908 |
| cpcra researchers present oi studies at vancouver. | the community programs for clinical research on aids (cpcra) presented several recent findings from clinical trials at the international conference on aids. weekly doses of fluconazole can safely prevent persistent yeast infections in hiv-infected women who frequently develop yeast infections of the mouth, vagina and throat. combination antibiotic therapy given intermittently is an effective initial treatment for persons with hiv-related tuberculosis. high dosages of clarithromycin should not be ... | 1996 | 11363924 |
| mac management. | results from recent studies are shedding light on ways to prevent and treat mycobacterium avium complex (mac) disease, a leading cause of death for people with aids. a two-drug combination treatment appears to be best. the food and drug administration (fda) has approved three drugs for the treatment of mac disease: rifabutin (mycobutin), clarithromycin (biaxin), and azithromycin (zithromax). two studies using clarithromycin show promising results and indicate that clarithromycin is superior to r ... | 1996 | 11363967 |
| icaac update on opportunistic infections. | recent research on the effects of opportunistic infections (ois) on hiv replication suggests that the ois can actually increase hiv replication through the production of cytokines. treatment options for thrush include antifungal treatments for early episodes and reserving fluconazole for patients with difficult to treat infections. other studies show that prevention and treatment of mycobacterium avium complex (mac) increases survival rates. drugs and dosages are described. | 1996 | 11363974 |
| jaw swelling in an hiv-infected man. | a case study is presented in the diagnosis and treatment of a late-stage hiv-infected male who presented with an irregularity in his jawline, a 4-cm firm mass near his left mandibular angle. the mass was diagnosed by ct scan as a greatly enlarged cervical node with a necrotic center, including enlargement of several other nodes. treatment ultimately involved the use of rifabutin and ethambutal. differential diagnosis ruled out a malignancy and pathologic studies showed that the mass was typical ... | 1996 | 11363991 |
| tuberculosis-like illness in a young man from thailand. | a case study is presented of a mid-20's, hiv-infected male visitor from thailand who became increasingly ill with tuberculosis-like symptoms. the question addressed is whether the patient should be treated for miliary tuberculosis or for disseminated mycobacterium avium complex (mac) infection pending further evaluation. it is argued that due to the frequency with which penicillium marneffei infection occurs in thai aids patients and the similarity of the symptoms to mac infection, such treatmen ... | 1996 | 11363992 |
| don't have a mac attack. how to fight aids-related mac. national institutes of health. | mycobacterium avium complex (mac) is a common opportunistic infection in people with hiv. it causes fever, night sweats, weight loss, fatigue, diarrhea and abdominal pain, and the bacteria that causes it is found everywhere. medicines can be given to strengthen the immune system and increase resistance to mac. patients need to consult with their doctors and follow their medical regimens to prevent mac. | 1997 | 11364037 |
| recent development in the treatment and prevention of disseminated mycobacterium avium complex (mac). | disseminated mycobacterium avium complex (dmac) is the third most common opportunistic infection in people with aids, infecting up to 50 percent of them. symptoms include high fever, weight loss, fatigue, diarrhea, poor appetite, night sweats, and anemia. diagnosis is by blood culture. results of two recent studies are presented, as well as treatment guidelines issued by a national panel. | 1996 | 11364267 |
| [the new age of hiv/aids. a special report on the xi international conference on aids]. | new treatments that are available promoted optimism at the xi international conference on aids, held in vancouver in july 1996. topics that were presented at the conference are highlighted, including a global analysis of the epidemic, possible eradication of the virus, pathogenesis of the hiv virus, detection of the viral load change in the blood, and the status of protease inhibitors. a brief report on the combination and activity of crixivan, azt and 3tc is presented. the dangers of opportunis ... | 1996 | 11364380 |
| latest opportunistic infection prevention guidelines. | although people with hiv are living longer than ever before, they continue to suffer from infections that are associated with low t4-cell counts. the u.s. public health service (phs) and the infectious diseases society of america (idsa) have updated the guidelines for preventing opportunistic infections, including their positions on when prophylaxis is indicated. summaries are given for preventing the following infections: cytomegalovirus (cmv), cryptosporidiosis, fungal infections, human papill ... | 1998 | 11365000 |
| update: prophylaxis for hiv opportunistic infections. | the u.s. public health service and the infectious diseases society of america recently updated the 1995 guidelines on prevention of opportunistic infections in hiv infected individuals. pcp prophylaxis has not been changed in the new guidelines. primary prevention strategies for toxoplasmosis encephalitis are described. preventive medication for tuberculosis is generally not recommended, especially for persons in high risk groups such as the homeless and injection drug users. significant changes ... | 1998 | 11365025 |
| update on opportunistic infections. | the use of highly active antiretroviral therapy (haart) can be effective for reducing the first onset of opportunistic infections (ois) and preventing their recurrence. while clinical studies are trying to determine the relationship between haart and delayed recurrence, it is recommended that patients currently on haart for oi prevention and maintenance not stop the therapy. updates are presented for the following topics: pneumonia vaccination, pneumocystis carinii pneumonia (pcp) prevention, my ... | 1997 | 11365373 |
| good news about hiv treatments. | new and stronger anti-hiv treatments are decreasing aids mortality and opportunistic infections statistics. studies in baltimore, new orleans, and france showed significant drops in new cases of cytomegalovirus (cmv), mycobacterium avium complex (mac), kaposi's sarcoma, and pcp. drug side effects and drug adherence remain problematic. it appears that even a short-term reduction in viral load can produce long-term improvement in health and increase t4 cell count. researchers speculate that hiv is ... | 1998 | 11365424 |
| investigational interleukins: the cutting edge of immune reconstitution. | hiv disables the immune system by destroying cd4+ cells, leading to increased risk of potentially life-threatening opportunistic infections, such as mycobacterium avium complex (mac), pneumocystis carinii pneumonia (pcp), and cytomegalovirus (cmv). boosting the immune cell counts will help combat these diseases. cutting-edge immune therapies involve one of several naturally occurring chemicals produced by immune cells, called cytokines. interleuken-2 (il-2) has been studied since 1983, and in th ... | 1998 | 11365485 |
| azithro once a week for mac. | azithromycin (zithromax) has been used to treat a number of infections, including mycobacterium avium complex (mac). a study using azithromycin to prevent mac shows the drug's effectiveness in reducing the outbreak of mac and also protecting from other infections, including pcp. this study involved 180 hiv-positive subjects, of which 89 received 1200 mg of azithromycin once a week, and 91 received a placebo once a week. fifteen percent of the treated subjects developed mac infections compared to ... | 1998 | 11365625 |
| i hear you knockin' (but you can't come in): potent new hiv therapies are shutting out opportunistic infections. | highly active antiretroviral therapy (haart) has positively impacted the epidemiology of opportunistic infections in hiv- infected patients. the following opportunistic infections and their responses to haart and prophylaxis recommendations are examined: pneumocystis carinii pneumonia (pcp), cytomegalovirus (cmv) disease, mycobacterium avium complex (mac) disease, and fungal diseases. the question of whether opportunistic infection prophylaxis should be continued in persons who respond to haart ... | 1998 | 11365645 |
| opportunistic infections update. | highly active antiretroviral therapy (haart) has effectively decreased the incidence of opportunistic infections (ois), and thereby reduced research efforts to find alternative treatments to prevent or treat ois. however, research on treating ois is still needed. for instance, it is suggested that people who are co-infected with hiv and hepatitis c virus (hcv) should not use protease inhibitors (pis), because both pis and hcv significantly strain the liver, and that could increase the risk of li ... | 1998 | 11365840 |
| no news is good news: opportunistic infections. | the 38th interscience conference on antimicrobial agents and chemotherapy (icaac) was notable for not having any oral sessions on opportunistic infections. this is an indication of the enormous success of combination antiretroviral therapy, which has greatly reduced the occurrences of opportunistic infections. hepatitis c was discussed at the conference, but it was treated as a co-morbid condition rather than an opportunistic infection. two studies addressed the question of stopping pneumocystis ... | 1998 | 11366129 |
| cmv. | cytomegalovirus (cmv) occurs 25 percent less often than it did before the advent of highly active antiretroviral therapy (haart), according to a recent study by the university of california at san francisco. cmv is the most common infection in hiv-positive persons with t-cell counts below 50, and it can cause blindness. researchers have also found that macrolide antibiotic treatment for mycobacterium avium complex (mac) may lead to resistance in people with aids who have been treated for mac in ... | 2000 | 11366342 |
| beware what you eat and drink, even while on haart. | people infected with hiv who are treated with highly active antiretroviral therapy (haart) are staying healthier for longer than ever before, but they still need to be cautious of exposure to foodborne and waterborne bacteria. the centers for disease control and prevention (cdc) lists several pathogens which can be dangerous to persons with hiv/aids, including mycobacterium avium complex (mac) and cryptococcosis. people with hiv who are infected by these pathogens tend to suffer from more severe ... | 1999 | 11366423 |
| opportunistic infections update. | the incidence of opportunistic infections (ois) has been steadily decreasing due, in part, to the use of effective combination therapy with a protease inhibitor. recently, however, an increase in ois has been noted, suggesting that some people have depleted much or all of the available therapies and can no longer keep their cd4+ counts high enough to fight off infections. this demonstrates the need to initiate or re-initiate preventative medications for ois. treatment of mycobacterium avium comp ... | 1999 | 11366735 |
| smoking: it doesn't make living with hiv any easier. | smoking is a well-recognized risk to health, particularly for people with hiv. hiv-positive smokers are more likely to develop pneumocystis carinii pneumonia (pcp), thrush, and oral hairy leukoplakia. the bacteria that causes mycobacterium avium complex (mac), a life-threatening infection found in many people with hiv, has been found in tobacco products and can survive the smoking process. suggestions to help people with hiv quit smoking include choosing the right approach, using smoking cessati ... | 1999 | 11367324 |
| foregoing prophylaxis: better safe than sorry? | the widespread use of highly active antiretrroviral therapy (haart) has coincided with a dramatic decline in the incidence of opportunistic infections. this effect has lead some people to question whether they should continue taking prophylaxis medications against diseases such as pneumocystis carinii pneumonia (pcp) and mycobacterium avium complex (mac). research on this topic presented at the 39th interscience conference on antimicrobial agents and chemotherapy (icaac) is described. | 1999 | 11367330 |
| opportunistic infections update. | the u.s. public health service and the infectious disease society of america issued new guidelines for the prevention of opportunistic infections (ois). the guidelines, which deal with the issues of starting and stopping both preventative and maintenance therapy, are provided in chart form. the ois addressed include candidiasis, cytomegalovirus (cmv), mycobacterium avium complex (mac), and tuberculosis (tb). contact information is provided. | 1999 | 11367355 |
| prophylaxis of opportunistic infections in adults and children with hiv infection. | preventing opportunistic infections is an important part of effective hiv care. prophylaxis is recommended in cases in which the incidence of the disease is high, the disease is associated with high levels of morbidity and mortality, and if there are treatments available that are effective and well tolerated. diseases for which prophylactic treatments are recommended include tuberculosis, pneumocystitis carinii pneumonia (pcp), and toxoplasmosis. treatment for mycobacterium avium complex (mac) a ... | 1995 | 11367408 |
| two cases of long lasting bacteremia due to mycobacterium avium complex despite new macrolides-containing regimens in patients with acquired immunodeficiency syndrome. | the prognosis of mycobacterium avium complex (mac) infection has been improved by new macrolides-containing regimens and the use of highly active antiretroviral therapy (haart) in the treatment of acquired immunodeficiency syndrome (aids). we report on two aids cases with long lasting bacteremia due to mac under this regimen. both patients experienced problems due to side effects from the anti-mac regimen and from an immune-reconstitution syndrome related to haart. mac infection persisted despit ... | 2001 | 11393423 |
| nef-deleted hiv-1 inhibits phagocytosis by monocyte-derived macrophages in vitro but not by peripheral blood monocytes in vivo. | hiv-1 infection impairs a number of macrophage effector functions, but the mechanism is unknown. we studied the role of hiv-1 nef in modulating phagocytosis by human monocytes and monocyte-derived macrophages (mdm). | 2001 | 11399976 |
| the significance of bronchoscopy for the diagnosis of mycobacterium avium complex (mac) pulmonary disease. | to investigate the usefulness of bronchoscopy for the diagnosis of mycobacterium avium complex (mac) pulmonary disease, we retrospectively reviewed the clinical charts, and radiographic and bacteriologic findings of all patients who were admitted to our hospital between 1994 and 2000, and who fulfilled the 1997 american thoracic society (ats) criteria for mac pulmonary infection. a total of 132 patients were diagnosed as affected by mac pulmonary disease during that period. of these, bronchoscop ... | 2001 | 11402614 |
| [profiles of expression of the therapeutic efficacy of krm-1648 in mice infected with mycobacterium avium complex at different challenge doses]. | studied were made on the profiles of the therapeutic efficacy of krm-1648 (krm) against mycobacterium avium complex (mac) infection, which was induced in mice at different challenge doses, in reducing bacterial growth in the visceral organs and altering the profiles of cytokine mrna expression at the sites of infection. first, bacterial growth in the lungs of mice infected with either high or low challenge doses of mac, was reduced due to krm treatment. this effect was noted even in the early ph ... | 2001 | 11449696 |
| telithromycin is active against mycobacterium avium in mice despite lacking significant activity in standard in vitro and macrophage assays and is associated with low frequency of resistance during treatment. | the activity of telithromycin, a new ketolide, was evaluated in vitro and in vivo against mycobacterium avium complex (mac) strains. the mic of telithromycin for several m. avium isolates obtained from the blood of aids patients ranged from 16 to >128 microg/ml (mic at which 90% of isolates are inhibited, >128 microg/ml), and the compound did show activity in the macrophage system at concentrations greater than 8 or 16 microg/ml, but this was dependent on the mac strain used. telithromycin was t ... | 2001 | 11451676 |
| obstructive granulomatous bronchiolitis due to mycobacterium avium complex in an immunocompetent man. | while the development of pulmonary disease due to mycobacterium avium complex (mac) infection is most commonly associated with underlying predisposing factors, this organism occasionally causes symptomatic disease in otherwise normal individuals. patients with mac pulmonary disease most often present with cavitating granulomas, but a spectrum of pathologic changes has been described. the authors present a case of mac pulmonary disease in an immunocompetent, middle-aged man with no identified pre ... | 2001 | 11464091 |
| induction of disseminated mycobacterium avium in simian aids is dependent upon simian immunodeficiency virus strain and defective granuloma formation. | mycobacterium avium complex (mac) is the most common disseminated bacterial disease in patients infected by the human immunodeficiency virus. although murine models of disseminated mac exist, they are primarily based on underlying genetic susceptibilities and cannot adequately address the complex interactions that occur between host, mycobacteria, and immunosuppressive lentivirus. to address this problem we have developed an experimental system to co-inoculate rhesus macaques with the simian imm ... | 2001 | 11485927 |
| unilateral bronchiectasis and esophageal dysmotility in congenital adult tracheoesophageal fistula. | tracheoesophageal fistulas (tef) in adults are most commonly neoplastic, and very rarely congenital in nature. we report a 45-year-old hispanic male with tef and initial presentation of minimal hemoptysis. the patient had radiographic evidence of unilateral upper lobe (rul) bronchiectasis, massive esophageal dilatation, and dysmotility. however, there was no evidence of esophageal malignancy, achalasia, or chagas' disease. bronchoscopy revealed a large tef in the posterior wall of trachea, which ... | 2001 | 11506303 |
| studies on macrolide antibiotics i. synthesis and antibacterial activity of erythromycin a 9-o-substituted oxime ether derivatives against mycobacterium avium complex. | a series of erythromycin a 9-o-substituted oxime ether derivatives have been synthesized and evaluated for antibacterial activity against mycobacterium avium complex (mac) and staphylococcus aureus. these compounds possessed stronger in vitro activity against mac including macrolide-resistant strains than clarithromycin (2), although in vitro antibacterial activities of these compounds were less than that of 2 against staphylococcus aureus. our studies found that several factors contribute to th ... | 2001 | 11558597 |
| changes in incidence and risk factors of mycobacterium avium complex infections in patients with aids in the era of new antiretroviral therapies. | the aim of the study presented here was to determine the incidence, risk factors and prognostic indicators of mycobacterium avium complex (mac) infection in hiv-infected subjects prior to and after the introduction of highly active antiretroviral therapy (haart). in the haart era, the incidence of mac infection decreased significantly from 3.7 to 0.9 per 100 person-years. using logistic regression analysis, a high acute physiology and chronic health evaluation (apache) iii score, a low number of ... | 2001 | 11561808 |
| simple and rational approach to the identification of mycobacterium tuberculosis, mycobacterium avium complex species, and other commonly isolated mycobacteria. | a novel pcr-restriction fragment length polymorphism analysis of the hsp65 gene was developed. the restriction patterns for mycobacterium tuberculosis and mycobacterium avium complex (mac) species were designed to be highly distinct, and the overall number of restriction patterns was designed to be limited. four hundred specimens (17 reference strains and 383 clinical isolates) were tested, of which 98 were m. tuberculosis and 132 were mac species. the assay was virtually 100% sensitive and spec ... | 2001 | 11574614 |
| underuse of primary mycobacterium avium complex and pneumocystis carinii prophylaxis in the united states. | little is known about the rates of mycobacterium avium complex (mac) and pneumocystis carinii (pcp) prophylaxis adherence to guidelines and how they have changed after introduction of effective antiretroviral therapy. | 2001 | 11707670 |
| studies on (beta,1-->5) and (beta,1-->6) linked octyl gal(f) disaccharides as substrates for mycobacterial galactosyltransferase activity. | the emergence of multi-drug resistant (mdr) strains of mycobacterium tuberculosis (mtb) and the continuing pandemic of tuberculosis emphasizes the urgent need for the development of new anti-tubercular agents with novel drug targets. the recent structural elucidation of the mycobacterial cell wall highlights a large variety of structurally unique components that may be a basis for new drug development. this publication describes the synthesis, characterization, and screening of several octyl gal ... | 2001 | 11711288 |
| characterization of a mycobacterium intracellulare variant strain by molecular techniques. | this paper describes a mycobacterium intracellulare variant strain causing an unusual infection. several isolates obtained from an immunocompromised patient were identified as members of the mycobacterium avium complex (mac) by the commercial accuprobe system and biochemical standard identification. further molecular approaches were undertaken for a more accurate characterization of the bacteria. up to seven different genomic sequences were analyzed, ranging from conserved mycobacterial genes su ... | 2001 | 11724827 |
| isolated intrathoracic presentation of mycobacterium avium complex in an immunocompetent child. | mycobacterium avium complex (mac) is a rare cause of isolated intrathoracic disease in the immunocompetent child; delays in diagnosis and treatment are common. the current case is an 11-month-old girl with symptoms, signs, and radiographic findings of bronchial obstruction. comparison of this case to the literature revealed that there is a characteristic presentation of intrathoracic mac infection in immunocompetent children (children aged 3 years or less, without exposure to mycobacterium tuber ... | 2001 | 11727018 |
| analysis of transforming growth factor-beta 1 (tgf-beta1) expression in human monocytes infected with mycobacterium avium at a single cell level by elispot assay. | transforming growth factor beta 1 (tgf-beta1) has been implicated in the pathogenesis of a number of diseases including infection with intracellular pathogens such as mycobacterium avium complex (mac). in this study, we developed an elispot assay for measurement of active tgf-beta1 produced by peripheral blood mononuclear cells (pbmc) from healthy individuals in response to lps or mac. the frequency of tgf-beta1 producing cells was significantly (p<0.04) higher in response to lps (10 microg/ml) ... | 2002 | 11730838 |
| presence of macrolide resistance in respiratory flora of hiv-infected patients receiving either clarithromycin or azithromycin for mycobacterium avium complex prophylaxis. | clarithromycin 500 mg po bid or azithromycin 1200 mg po weekly is recommended as first line prophylaxis for mycobacterium avium complex (mac) in patients with hiv infection whose cd4 counts are <50 cells/microl. hiv-infected patients with cd4+ t-cell counts <200 cells/microl were randomized to receive either clarithromycin 500 mg po bid or azithromycin 1200 mg po weekly for 12 weeks. nasopharyngeal swabs for streptococcus pneumoniae and haemophilus influenzae plus an anterior nare culture for st ... | 2001 | 11742432 |
| pharmacophore mapping of a series of 2,4-diamino-5-deazapteridine inhibitors of mycobacterium avium complex dihydrofolate reductase. | pharmacophore hypotheses were developed for a series of 2,4-diamino-5-deazapteridine inhibitors of mycobacterium avium complex (mac) and human dihydrofolate reductase (hdhfr). training sets consisting of 20 inhibitors were selected in each case on the basis of the information content of the structures and activity data as required by the hypogen program in the catalyst software. in the case of mac dhfr inhibitors, the best pharmacophore in terms of statistics and predictive value consisted of fo ... | 2002 | 11754578 |
| azithromycin prophylaxis for mycobacterium avium complex during the era of highly active antiretroviral therapy: evaluation of a provincial program. | mycobacterium avium complex (mac) disease was evaluated in a provincial program of azithromycin prophylaxis. highly active antiretroviral therapy (haart) was prescribed to 383 (65%) of 587 patients eligible for mac prophylaxis (cd4 <75 cells/mm3). by use of an intent-to-treat analysis, mac disease was observed in 21 of 271 patients who did not receive prophylaxis (incidence rate, 8 events per 100 person-years). mac events occurred in 10 of 316 patients who received azithromycin (2.37 events per ... | 2002 | 11774085 |
| discontinuation of secondary prophylaxis against disseminated mycobacterium avium complex infection and toxoplasmic encephalitis. | we retrospectively studied outcomes for patients infected with human immunodeficiency virus who received highly active antiretroviral therapy (haart) and had stopped receiving secondary prophylaxis against toxoplasmic encephalitis (te) or disseminated mycobacterium avium complex (mac) infection. nineteen patients had a history of te, and 26 had a history of disseminated mac infection. the median duration of secondary prophylaxis was 27 months, and the median duration of haart before discontinuat ... | 2002 | 11810599 |
| rifabutin-induced cystoid macular oedema. | rifabutin is a semi-synthetic antimycobacterial agent mainly used in the treatment of mycobacterium avium-complex (mac) in aids patients. rifabutin-induced anterior uveitis has been reported previously. we report the case of a rifabutin-induced cystoid macular oedema (cmo) in an immunocompetent patient with pulmonary mac infection. as far as we know, cmo secondary to rifabutin therapy has not been described previously. | 2002 | 11815593 |
| surgery for mycobacterium avium complex lung disease in the clarithromycin era. | since the introduction of clarithromycin, it has been assumed that pulmonary mycobacterium avium complex (mac) disease can be treated with medication alone. this study examines whether surgery can still play an important role in the management of mac lung disease in the current era. | 2002 | 11825742 |
| studies on n-octyl-5-(alpha-d-arabinofuranosyl)-beta-d-galactofuranosides for mycobacterial glycosyltransferase activity. | the mycobacterial cell wall is a potential target for new drug development. herein we report the preparation and activity of several n-octyl-5-(alpha-d-arabinofuranosyl)-beta-d-galactofuranoside derivatives. a cell-free assay system has been utilized for determination of the ability of disaccharide analogues to act as arabinosyltransferase acceptors using [14c]-dpa as the glycosyl donor. in addition, in vitro inhibitory activity has been determined in a colorimetric broth microdilution assay sys ... | 2002 | 11836099 |
| antimicrobial activities of clarithromycin, gatifloxacin and sitafloxacin, in combination with various antimycobacterial drugs against extracellular and intramacrophage mycobacterium avium complex. | we studied the activities of clarithromycin and fluoroquinolones (gatifloxacin, sitafloxacin, levofloxacin) in combination with other antimycobacterial drugs against extracellular and intramacrophage mycobacterium avium complex (mac). clarithromycin potentiated the activities of rifampicin and rifalazil against both extracellular and intramacrophage mac. in contrast, all the test quinolones exhibited antagonistic effects against extracellular mac when combined with either clarithromycin or rifam ... | 2002 | 11850167 |
| [pulmonary complications in patients with aids]. | hiv infection was first reported in 1981 in usa. it has been 20 years since then. owing to understandings of pathogenesis of this disease and development of new drugs such as the hiv-specific protease inhibitor (pi), prognosis of disease has been tremendously improved. especially after 1997 in japan, the strategy of anti-hiv treatment shifted from two drugs combination to three drugs combination, which is called highly active antiretoviral therapy (haart). haart was so effective that prevalence ... | 2002 | 11855078 |
| lack of significant cross-reactivity between leishmania serology and mycobacteriosis in patients infected with hiv-1. | objective: to determine the existence of cross-reactions between leishmania serology and mycobacteriosis in patients infected with hiv-1. patients and methods: hiv-positive individuals, with culture-proven episodes of tuberculosis or disseminated mycobacterium avium complex (mac) infection, were identified from the data files of our microbiology laboratory. patients were included if leishmania serology had been performed within a period of 2 months before and 1 month after the diagnosis of mycob ... | 1999 | 11856263 |
| prospective 7-year monitoring of mac bacteremia in hiv-positive swedish patients. | objective: to record the cumulative incidence of mycobacterium avium complex (mac) bacteremia among hiv-infected patients and to study colonization in relation to symptoms of infection. methods: in a prospective study, 61 patients with a cd4 count less-than-or-eq, slant200x106/l were followed by cultures from sputum, feces and blood every 3--6 months and for development of mac bacteremia and clinical symptoms. the main end-points were mac bacteremia and death. results: from the start in november ... | 1998 | 11864342 |
| mycobacterium avium complex peritonitis in an aids patient. | mycobacterium avium complex (mac) frequently disseminates in aids patients, where the gastrointestinal tract is a major target organ. while ascites in aids patients is common, peritonitis secondary to mac is rare. we describe the first case of mac peritonitis in an aids patient without underlying cirrhosis, portal hypertension, chylous ascites or peritoneal dialysis. this case highlights the need to be aware of atypical presentations of mac disease in aids patients with a history of disseminated ... | 2001 | 11868772 |
| pulmonary infections in children with hiv infection. | the epidemic of pediatric acquired immunodeficiency syndrome (aids) in the united states, which peaked during the mid-1980s and early 1990s, was characterized by a variety of opportunistic infections in children infected with human immunodeficiency virus (hiv), often as the presenting illness of their hiv infection. pneumocystis carinii pneumonia (pcp) during infancy was responsible for significant morbidity and mortality, followed by many other opportunistic infections, including recurrent, ser ... | 2002 | 11891517 |
| association of adherence to mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome. | high-level adherence to regimens of combination antiretroviral therapy and prophylactic medications for opportunistic infections (ois) is crucial to their success. however, little is known about the association between adherence to these life-sustaining therapies and such clinical outcomes as progression of acquired immune deficiency syndrome (aids) or development of ois. we assessed adherence to regimens of antiretroviral and mycobacterium avium complex (mac) prophylactic medications in 643 pat ... | 2002 | 11915003 |
| mycobacterial diseases and hiv. | this article focuses on tuberculosis (tb) and mycobacterium avium complex (mac), as these are the most important of the mycobacterioses in hiv-infected patients. it is estimated that in 1999, hiv-related tb reached 1000000 cases and caused 30% of the 2500000 aids-related deaths. in hiv-infected patients, tb may have unusual clinical features and can cause diagnostic difficulties. despite the effectiveness of modern short-course treatment, mortality due to hiv-related tb remains high both during ... | 2002 | 11956499 |
| mycobacterium avium complex lung disease in immunocompetent patients: radiography-ct correlation. | this study aimed to describe and correlate the chest radiography and ct findings of mycobacterium avium complex (mac) lung disease in immunocompetent patients. 26 patients fulfilled the american thoracic society criteria for mac lung disease and underwent chest radiography and ct within 6 weeks of positive cultures. all abnormalities and predominant lobar involvement were recorded and abnormalities on chest radiography were correlated with those on ct. the images were evaluated by two chest radi ... | 2002 | 12000692 |
| heterozygosity for ccr5-delta32 but not ccr2b-64i protects against certain intracellular pathogens. | to determine the association between ccr5 and ccr2b genotype and the clinical manifestation of first and subsequent aids-defining illnesses (adis). | 2002 | 12010355 |
| mycobacterium avium complex-associated cholecystitis in an hiv-infected woman. | mycobacterium avium complex (mac) is commonly associated with fever, fatigue, nausea, diarrhea, and cytopenias related to invasion of the intestine and bone marrow. infection and clinical disease has been reported in other organs as well. we report the first case of cholecystitis associated with mac infection of the gallbladder. | 2002 | 12055027 |