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).