Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026916 (MAC)
 5,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prevention of opportunistic infections contributes to improved quality of life and survival in individuals with acquired immunodeficiency syndrome (AIDS). Agents which are more effective and convenient, less costly, and better tolerated are needed for multiple organism primary prophylaxis. Azithromycin, azalide with high and prolonged intracellular levels, promise to provide to protection against Mycobacterium avium complex (MAC) disease in those with advanced AIDS when given weekly. A large trail comparing rifabutin (300 mg daily), a currently approved primary prophylactic agent for MAC, with azithromycin (1200 mg weekly) has been completed and is under analysis. If weekly azithromycin provides equivalent or better protection from disseminated MAC, the cost effectiveness and convenience of MAC prophylaxis may be improved.
Int J STD AIDS 1996
PMID:Azithromycin in the prophylaxis of opportunistic infections in AIDS. 865 26

Clarithromycin can ameliorate symptoms and improve survival in disseminated Mycobacterium avium complex (DMAC) infection. Optimal combinations of this drug with other agents remain unknown. Granulocyte colony stimulating factor (G-CSF) is a cytokine that can improve phagocytosis of M. avium complex in vitro. We aim to determine if G-CSF administration is associated with improved survival in patients with DMAC in a retrospective, cohort study. Case records from 1991 to 1995 of 91 patients with DMAC at Parkland Memorial Hospital were reviewed for date of initial DMAC diagnosis, baseline CD4 count, race, sex, antiretroviral use, G-CSF use, therapy for DMAC (clarithromycin, ethambutol, ciprofloxacin and rifabutin) and date of death. Of 91 cases identified, 25 were treated with G-CSF and 66 never received this drug. Baseline characteristics were similar in each group including CD4 count (40 cells/mm3 vs 33 cells/mm3, P=0.68), clarithromycin use (18 patients vs 52 patients, P=0.90), and antiretroviral use (20 patients vs 42 patients, P=0.21). Subjects treated with G-CSF lived longer than those who did not receive this drug (355 days vs 211 days, P<0.01). In the subgroup treated with clarithromycin, G-CSF was also associated with increased survival (377 days vs 252 days, P<0.01). Cox proportional hazards model showed a decreased risk of death in patients treated with G-CSF (RH=0.22, P<0.01), clarithromycin (RH=0.13, P<0.01) and ethambutol (RH=0.51, P=0.02). Ciprofloxacin and rifabutin use did not influence survival. These data support the use of clarithromycin and ethambutol in the treatment of DMAC. Addition of G-CSF to a regimen of clarithromycin and ethambutol may increase survival in DMAC and should be studied prospectively.
Int J STD AIDS 1998 Jul
PMID:G-CSF association with prolonged survival in HIV-infected patients with disseminated Mycobacterium avium complex infection. 969 94

A descriptive retrospective review of 26 patients with mycobacterial infection; 7 Mycobacterium tuberculosis (MTB), 17 Mycobacterium avium complex (MAC), one M. xenopei and one M. kansasii. Diagnosis of non-tuberculous mycobacteria (NTM) was made mainly from blood in 68%, with biopsy material initially useful in 68%. All MTB were fully sensitive. No patients received MAC chemoprophylaxis, yet resistance to rifabutin, ciprofloxacin and ethambutol was noted. It is important to examine the UK experience of mycobacterial infection; individual centres may find it useful to review infecting organisms and resistance patterns.
Int J STD AIDS 1998 Oct
PMID:A UK centre's experience of mycobacterial infections in HIV-infected patients. 981 14

Variation in the clinical stage at which AIDS is diagnosed has hindered the ability of investigators to generate survival estimates which are stable across study cohorts. As a result, little is known about how clinical and sociodemographic factors are associated with survival, independent of AIDS diagnosis stage. By estimating survival following seroconversion while adjusting for baseline CD4 lymphocyte count, the present study generated survival determinants which were unconfounded by time-related changes in AIDS diagnosis. This study's findings indicate that the following factors were associated with significant decreases in HIV-related survival: older age; self-report of no known HIV transmission risk factors; and presence of cytomegalovirus, Mycobacterium avium complex, and Pneumocystis carinii pneumonia. Furthermore, survival decreased in a monotonic fashion with decreases in baseline CD4 count and with increases in calendar period. While this study's findings are consistent with previous investigators' reports of AIDS survival determinants, it will be important for future investigators to refine and update estimates of HIV-related survival determinants as clinical care for HIV-infected patients continues to improve.
Int J STD AIDS 1999 Jan
PMID:Determinants of survival in HIV-positive patients. 1021 25

Disseminated Mycobacterium avium complex (DMAC) infection is associated with increased morbidity and mortality in HIV-infected individuals. The combination antibiotic regimens containing clarithromycin can decrease symptoms and improve survival in patients with DMAC, however, optimal therapy remains to be defined. Quinolones have been widely used in the treatment of DMAC but their utility has not been established. A retrospective cohort study of DMAC infection was established in a metropolitan hospital providing comprehensive care to over 3000 HIV-infected individuals. Medical records of patients with DMAC diagnosed at the Parkland Memorial Hospital from 1991 to 1994 were reviewed for therapeutic regimens for DMAC, concomitant therapy for HIV and Pneumocystis carinii prophylaxis and date of death. Subjects were included if they were treated with clarithromycin and ethambutol. Cases were defined as those patients who received more than 30 days of ciprofloxacin as therapy for DMAC in addition to the other drugs that they received. The primary endpoint was the time to death from the data of DMAC diagnosis. Covariates effecting survival were analysed through the Cox proportional hazards model. Eighty-nine subjects with DMAC who were treated with clarithromycin and ethambutol were identified. Fifty-eight received ciprofloxacin in addition to clarithromycin and ethambutol. The time to death was significantly better in those subjects who were treated with ciprofloxacin than those who were not (489 days vs 281 days, P=0.01). The sole significant predictor of improved survival on Cox proportional hazards model was ciprofloxacin therapy. Subjects treated with combination of clarithromycin, ethambutol and ciprofloxacin had improved survival over those treated with clarithromycin and ethambutol alone.
Int J STD AIDS 1999 Dec
PMID:A retrospective study of the addition of ciprofloxacin to clarithromycin and ethambutol in the treatment of disseminated Mycobacterium avium complex infection. 1063 59

Our objective was to compare the effect of 2 regimens for treatment of Mycobacterium avium complex (MAC) bacteraemia in an HIV-positive population on symptoms and health status outcomes using a substudy of an open-label randomized controlled trial. The study was conducted in 24 hospital-based human immunodeficiency virus (HIV) clinics in 16 Canadian cities. Patients had HIV infection and MAC bacteraemia and were given either rifampin 600 mg, ethambutol 15 mg/kg daily, clofazimine 100 mg daily and ciprofloxacin 750 mg twice daily (4-drug arm) or rifabutin 600 mg daily (amended to 300 mg daily in mid-trial), ethambutol 15 mg/kg daily and clarithromycin 1000 mg twice daily (3-drug arm). The primary health status outcome was the change on the 8-item symptom subscale of the Medical Outcome Study (MOS)-HIV Health Survey adapted for MAC. Changes on other MOS-HIV subscales and on the Karnofsky score were also evaluated. Patients on the 3-drug arm had better outcomes on the MOS-HIV symptom subscale at 16 weeks (P=0.06), with statistically significant differences restricted to night sweats and fever and chills (P < 0.001). The proportion of patients improving on the symptom subscale relative to baseline was 55% on the 3-drug arm and 40% on the 4-drug arm. Patients on the 3-drug arm also had better Karnofsky score at 16 weeks (P < 0.001) and better outcomes on the social function, mental health, energy/fatigue, health distress and cognitive function subscales of the MOS-HIV. The 3-drug arm is superior to the 4-drug arm in terms of impact on MAC-associated symptoms, functional status and other aspects of health status.
Int J STD AIDS 2000 Apr
PMID:Symptomatic and health status outcomes in the Canadian randomized MAC treatment trial (CTN010). Canadian HIV Trials Network Protocol 010 Study Group. 1077 83

Risk factors for anaemia and cumulative incidence of anaemia were examined in a longitudinal cohort study of 622 injection drug users (IDUs) (8885 visits) in Baltimore, Maryland, from 1988 to 2000. At enrollment, 19.6% subjects were anaemic (16.1% of men and 30.5% of women, P<0.0001) and 8.4% had microcytic anaemia (6.7% of men and 14.0% of women, P=0.006). Cumulative incidence of anaemia was 82.2% (87.9% of men and 100% of women, P<0.0001) during a median of 7.5 years follow-up. Factors associated with anaemia included age (per 5 year increase, odds ratio (OR)=1.22; 95% confidence interval (CI): 1.10, 1.36), female gender (OR=1.62; 95% CI: 1.16, 2.27), CD4+ lymphocyte count <200 cells/microl (OR 1.85; 95% CI: 1.52, 2.24), weight loss (OR 1.55; 95% CI: 1.26, 1.91), oral thrush (OR 1.53; 95% CI: 1.21, 1.94), Mycobacterium avium complex infection (OR 1.30; 95% CI: 1.04, 1.64), and zidovudine use (OR 1.24; 95% CI: 1.04, 1.48). Higher body mass index (OR 0.92; 95% CI: 0.88, 0.95) and marijuana use (OR 0.75; 95% CI: 0.61, 0.92) were associated with a lower risk of anaemia. The cumulative incidence of anaemia is high among IDUs, and women are at highest risk of anaemia.
Int J STD AIDS 2002 Feb
PMID:Risk factors and cumulative incidence of anaemia among HIV-infected injection drug users. 1224 37

Ethambutol is commonly used for the treatment of tuberculous and atypical mycobacterial infection. Central nervous system (CNS) toxicity other than optic neuropathy is not widely reported. A 40-year-old man with advanced HIV infection and Mycobacterium avium complex infection experienced rapid cognitive decline after commencement of ethambutol, and symptoms fully resolved with cessation.
Int J STD AIDS 2007 Apr
PMID:Ethambutol toxicity manifesting as acute onset psychosis. 1750 84

Chylous ascites related to Mycobacterium avium complex (MAC) in HIV-infected patients is rare, with only six cases reported in the English literature. We report a series of six cases from a single institution. During the past six years, chylous ascites was diagnosed in six (35%) of 17 AIDS patients, all of whom had previously been diagnosed with intra-abdominal MAC immune reconstitution syndrome (MAC-IRS). A review of medical records identified no other cases of chylous ascites among HIV-positive patients over the past 13 years (1994-2007), and the incidence was estimated at one in 2248 HIV-positive admissions. The ascitic fluid had a milky appearance and a median triglyceride level of 4.07 mmol/L (range 3.19-29.6 mmol/L) (360 mg/dL, range 282-2620 mg/dL). After a median follow-up of 20 months, five (83%) of six patients survived. Chylous ascites is a late complication of intra-abdominal MAC-IRS, and is usually associated with a favourable prognosis.
Int J STD AIDS 2009 Apr
PMID:Chylous ascites: a late complication of intra-abdominal Mycobacterium avium complex immune reconstitution syndrome in HIV-infected patients. 1930 80

Here we report two cases of infection caused by Mycobacterium arupense in HIV-infected patients who had received Mycobacterium avium complex medication after primary treatment with antituberculous drugs. The causative agents were isolated from the respiratory and blood specimens of the patients. The identification was based on conventional and molecular tests. Our study provides further evidence on the role of this microorganism in clinical cases.
Int J STD AIDS 2013 Jun
PMID:Mycobacterium arupense infection in HIV-infected patients from Iran. 2397 Jul 53


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