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).