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Query: UMLS:C0026916 (MAC)
 5,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection with an avirulent strain of Semliki Forest virus (SFV-A7) facilitates the development of experimental allergic encephalomyelitis (EAE) in a genetically resistant BALB/c mouse strain. Irradiation which is necessary for EAE induction caused a decrease in the total number of lymphocytes and an increase in CD4+/CD8+ T cell ratio in the spleen of BALB/c mice. EAE induction increased the ratio further until clinical and histological signs of EAE appeared. Entry of perivascular CD4+ and CD8+ cells preceded the onset of clinical signs and the appearance of MAC-1+ cells in the central nervous system (CNS). In the acute phase of EAE, cellular infiltrates, which were sparse, consisted mainly of MAC-1+ cells and a few CD4+ and CD8+ cells. Inflammatory cells gradually disappeared during the recovery phase. SFV-A7 infection after irradiation and EAE induction did not significantly change the CD4+/CD8+ ratio in the spleen or in the CNS infiltrates but enhanced the entry of inflammatory cell into the CNS. Similar perivascular cell influx was also seen in untreated mice infected with SFV-A7. We conclude that observed rapid reduction of splenic mononuclear cells and increase of the CD4+/CD8+ T cell ratio caused by irradiation prior EAE induction are early crucial events in disease induction in this resistant strain of mice. SFV-A7 infection, which further facilitates the development of EAE, does not induce immunoregulatory changes but provides its effect by enhancing the entry of inflammatory cells into the CNS. The combination of these two mechanisms thus effectively breaks the natural resistance against EAE in this genetically resistant mouse strain.
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PMID:Facilitation of experimental allergic encephalomyelitis by irradiation and virus infection: role of inflammatory cells. 796 84

Otherwise infrequent, infections by non-tuberculous or atypical mycobacteria are now rising in AIDS. Infection with the Mycobacterium avium complex (MAC) is now the most frequent opportunistic bacterial infection, because of better detection of HIV positive patients. The incidence, which is probably underestimated, is now 14-33% in France. The Mycobacterium avium complex is responsible for 96% of infections by atypical mycobacteria in AIDS patients. Diagnosis of infection by MAC is bacteriological. The clinical picture is non-specific and associates high fever, profuse sweating, weight loss and asthenia, all of which make a severe alteration to the general condition. This infection persists in AIDS patients to a late phase of evolution where Immunodeficiency is profound, that is when the level of CD4 lymphocytes is low. Because of this, it is an increasing and preoccupying problem in patients, since it involves the prognosis of life. This shows the importance of prophylactic treatment for this pathology.
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PMID:[A new prophylactic agent in AIDS: Ansatipine. Disseminated Mycobacterium avium complex infection is now the most frequent of the opportunistic bacterial infections in AIDS]. 803 59

Infections caused by Mycobacterium avium intracellulare have become worrying because of their higher frequency, their new tendency to diffuse in all tissues (notably the blood) and the lack of curative treatment. The mortality rate remains high and the survival of patients after AIDS is diagnosed is estimated at 7.4 months. The effectiveness of new antimycobacterial drugs, observed in experiments on beige mice, has not yet been confirmed. In 18 patients suffering from this infection, either disseminated (88 percent) or localized in the lung (12 percent), a 12-week treatment with the clarithromycin-clofazimine combination has succeeded in sterilizing the pathological samples. Most patients reported a distinct improvement in their general condition, with fall of temperature, disappearance of most other symptoms, weight gain and better quality of life. Treatment was interrupted in 1 patient owing to liver toxicity. In this study the median survival of the patients after the Mycobacterium avium complex has been estimated at 11.4 months after the diagnosis of AIDS at 28.9 months.
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PMID:[Mycobacterium avium intracellulare infections. Treatment with a clarithromycin-clofazimine combination. 18 cases]. 812 3

Infection due to the Mycobacterium avium complex (MAC) is the most common opportunistic disease of bacterial origin among patients with AIDS in the United States. The incidence of disseminated disease due to MAC (DMAC) has risen dramatically in recent years. The risk of developing DMAC increases as the CD4+ lymphocyte count declines to < 100/mm3. Preliminary analyses of several studies suggest that gender, racial or ethnic group, and individual risk factors for human immunodeficiency virus infection do not influence the incidence of DMAC but that prior Pneumocystis carinii pneumonia, the development of severe anemia, or the interruption of antiretroviral therapy may increase risk. Both the respiratory and the gastrointestinal tracts probably serve as portals of entry for MAC. Colonization may potentiate the risk of DMAC but does not always precede dissemination. Patients with AIDS and DMAC have a shorter duration of survival than do those with AIDS but without DMAC. While treatment for DMAC may extend survival, no well-controlled, prospective, randomized clinical trial has documented this point. Most patients with AIDS and DMAC have disseminated multiorgan disease; the most frequently described symptoms include fever, night sweats, weight loss or wasting, diarrhea, and abdominal pain. The most commonly identified laboratory abnormalities are anemia and elevated serum levels of alkaline phosphatase. Localized disease syndromes related to MAC infection occur less often.
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PMID:Disease due to the Mycobacterium avium complex in patients with AIDS: epidemiology and clinical syndrome. 820 73

We discuss here our experience with Mycobacterium avium complex (MAC) infection in 446 HIV-positive patients. MAC was found in 13 cases (2.9%): 10 males, 3 females, age range 21-47 years. Infection was disseminated in 10 cases and limited to the lung in 3. CD4+ cells were, on average, 48 per microliters. At clinical onset, all patients suffered from fever and weight loss, 10 from anemia, and 5 from diarrhea. MAC was found in its disseminated form in cultures of blood (10 patients), stool (5 patients) and urine (1 patient). Broncho-alveolar lavage seemed to be the most specific diagnostic method for lung infection. Twelve patients were treated with a multi-drug regimen consisting of an association of 4 or 5 antibiotics, selected on the basis of antibiogram, from the following: clofazimine, rifabutin, ciprofloxacin, ethambutol, isoniazid, amikacin and piazofolin. Mean survival of patients was 91.7%, 83.4%, 71.8% and 58.4% at 4, 5, 6 and 7 months of treatment respectively. Although the mean survival of the treated group is similar to that of untreated patients, multi-drug therapy seems to improve quality of life inasmuch as it brings temperature to normal and enables weight gain. Dissemination was never observed after treatment in patients with pulmonary infection only.
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PMID:[Retrospective study of Mycobacterium avium complex infection in the acquired immunodeficiency syndrome]. 821 80

Infections with Mycobacterium avium complex (MAC) are the next most common complication in AIDS patients, and disseminated MAC infection is considered as an indicator disease of AIDS. Bacteriological and clinical features of MAC infection complicated with AIDS were reviewed. The number of AIDS patients in Japan has been increasing in a similar rate as in USA and Africa, so the members of Japanese Society for Tuberculosis should be ready for medical care of AIDS patients complicated with mycobacterial infections.
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PMID:[AIDS and Mycobacterium avium complex infection]. 843 29

Infections caused by mycobacteria other than tuberculosis (MOTT), especially Mycobacterium avium complex (MAC), are common in AIDS patients, but rare in immunocompetent persons. The route of transmission is unknown, but tap water could provide a possible source of infection: MAC was isolated from tap water in the U.S.A. but this has not been reported in Germany. We therefore investigated tap water in Berlin for the presence of mycobacteria and compared radiometric (Bactec) and standard plate culture methods processing large volumes of water samples. The Bactec method yielded equal results compared to standard methods but had the advantage of easy handling. Mycobacteria were isolated from 50/118 (42.4%) samples and from 21/30 (70%) sites. The most frequently isolated species was Mycobacterium gordonae (from 28% samples and from 53.3% sites); MAC was isolated from two samples only (1.7%).
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PMID:Isolation of atypical mycobacteria from tap water in hospitals and homes: is this a possible source of disseminated MAC infection in AIDS patients? 852 30

Gastrointestinal diseases in HIV-infected patients mainly affect the bowel, the oesophagus, and the liver. Most of the hepatic diseases are due to opportunistic infections and associated to AIDS. In the advanced AIDS disease Mycobacterium avium intracellulare is the most frequent bacterial infections agent. Mycobacterium tuberculosis is often diagnosed in less immunocompromised patients. Viral hepatitis (A, B, C, D) is more often diagnosed in HIV-infected patients than in non-infected controls. Non-Hodgkin's lymphoma of the liver is a relatively frequent tumour in HIV-infected patients. Kaposi's sarcoma may also affect the liver. Infections with the cytomegalovirus or cryptococci mainly affect the biliary system causing acalculous cholecystitis or secondary sclerosing cholangitis. In addition to clinical and laboratory diagnostics sonographic and computer tomographic examinations are important. The diagnostic power of sonographic and computer tomographic examinations can be increased by guided biopsies. Biliary diseases can be diagnosed by retrograde endoscopic diagnostic investigations (ERC, ERCP). This overview resumes the most important diagnostic and differential diagnostic data in HIV-associated liver and biliary tract diseases.
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PMID:[HIV infection: findings in liver and bile ducts]. 865 98

Infection with Mycobacterium avium complex (MAC) may cause a serious disseminated bacterial infection in up to 40% of patients with advanced HIV infection. Disseminated MAC has a negative impact on quality of life and contributes significantly to morbidity and mortality. Prompt diagnosis and aggressive treatment can diminish those effects. Disseminated disease can be prevented in many patients with the use of rifabutin prophylaxis. Nurses play an important role in evaluating symptoms and educating patients about the prevention and treatment of disseminated MAC.
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PMID:Mycobacterium avium complex infection in AIDS: clinical features, treatment, and prevention. 878 15

The incidence of tuberculosis in the developed countries has recently started to rise again due to increased migration, a higher rate of direct transmission of Mycobacterium tuberculosis, and co-infection with HIV. The impact of the latter on the pathogenesis and presentation of tuberculosis is summarised. Important measures to prevent the further spread of tuberculosis include rapid diagnosis, prompt isolation of infectious patients, adequate control of treatment compliance, as well as surveillance of local resistance patterns. Disease due to the Mycobacterium avium complex is more frequent among HIV-infected patients in Central Europe than tuberculosis, and its development in the presence of immune deficiency seems to be mainly the result of a new infection with this ubiquitous microorganism rather than the reactivation of a previously acquired infection. It has a significant impact on mortality. The diagnosis of Mycobacterium avium complex infection requires a high degree of conjecture because most of the symptoms are non-specific, such as fever, night sweats, weight loss and anaemia. Promptly initiated treatment significantly prolongs the survival time of those affected by comparison with untreated patients.
Infection
PMID:Epidemiological and clinical aspects of mycobacterial infections. 903 44


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