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. 1992 Aug;157(2):144–148.

Mycobacterium avium complex and Mycobacterium tuberculosis in patients infected with the human immunodeficiency virus.

K M Kerlikowske 1, M H Katz 1
PMCID: PMC1011232  PMID: 1441463

Abstract

Primary care physicians play an important role in identifying and treating bacterial infections in adults infected with the human immunodeficiency virus (HIV). Mycobacterium avium complex and Mycobacterium tuberculosis are pathogens that can cause systemic or local infection in these patients. We review the epidemiology, pathogenesis, clinical presentation, and principles of treatment for these two mycobacterial pathogens. Because M tuberculosis disease is preventable and curable and yet communicable, physicians should maintain a high degree of suspicion for tuberculosis in HIV-infected adults. In comparison, the goal of treating M avium complex in patients with advanced HIV disease is to reduce constitutional symptoms and improve survival.

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Selected References

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  1. Barnes P. F., Bloch A. B., Davidson P. T., Snider D. E., Jr Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991 Jun 6;324(23):1644–1650. doi: 10.1056/NEJM199106063242307. [DOI] [PubMed] [Google Scholar]
  2. Cappell M. S., Schwartz M. S., Biempica L. Clinical utility of liver biopsy in patients with serum antibodies to the human immunodeficiency virus. Am J Med. 1990 Feb;88(2):123–130. doi: 10.1016/0002-9343(90)90460-u. [DOI] [PubMed] [Google Scholar]
  3. Chiu J., Nussbaum J., Bozzette S., Tilles J. G., Young L. S., Leedom J., Heseltine P. N., McCutchan J. A. Treatment of disseminated Mycobacterium avium complex infection in AIDS with amikacin, ethambutol, rifampin, and ciprofloxacin. California Collaborative Treatment Group. Ann Intern Med. 1990 Sep 1;113(5):358–361. doi: 10.7326/0003-4819-113-5-358. [DOI] [PubMed] [Google Scholar]
  4. Daley C. L., Small P. M., Schecter G. F., Schoolnik G. K., McAdam R. A., Jacobs W. R., Jr, Hopewell P. C. An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction-fragment-length polymorphisms. N Engl J Med. 1992 Jan 23;326(4):231–235. doi: 10.1056/NEJM199201233260404. [DOI] [PubMed] [Google Scholar]
  5. Dautzenberg B., Truffot C., Legris S., Meyohas M. C., Berlie H. C., Mercat A., Chevret S., Grosset J. Activity of clarithromycin against Mycobacterium avium infection in patients with the acquired immune deficiency syndrome. A controlled clinical trial. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):564–569. doi: 10.1164/ajrccm/144.3_Pt_1.564. [DOI] [PubMed] [Google Scholar]
  6. Di Perri G., Cruciani M., Danzi M. C., Luzzati R., De Checchi G., Malena M., Pizzighella S., Mazzi R., Solbiati M., Concia E. Nosocomial epidemic of active tuberculosis among HIV-infected patients. Lancet. 1989 Dec 23;2(8678-8679):1502–1504. [PubMed] [Google Scholar]
  7. Edlin B. R., Tokars J. I., Grieco M. H., Crawford J. T., Williams J., Sordillo E. M., Ong K. R., Kilburn J. O., Dooley S. W., Castro K. G. An outbreak of multidrug-resistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. N Engl J Med. 1992 Jun 4;326(23):1514–1521. doi: 10.1056/NEJM199206043262302. [DOI] [PubMed] [Google Scholar]
  8. Ellner J. J., Goldberger M. J., Parenti D. M. Mycobacterium avium infection and AIDS: a therapeutic dilemma in rapid evolution. J Infect Dis. 1991 Jun;163(6):1326–1335. doi: 10.1093/infdis/163.6.1326. [DOI] [PubMed] [Google Scholar]
  9. Graham N. M., Nelson K. E., Solomon L., Bonds M., Rizzo R. T., Scavotto J., Astemborski J., Vlahov D. Prevalence of tuberculin positivity and skin test anergy in HIV-1-seropositive and -seronegative intravenous drug users. JAMA. 1992 Jan 15;267(3):369–373. [PubMed] [Google Scholar]
  10. Hawkins C. C., Gold J. W., Whimbey E., Kiehn T. E., Brannon P., Cammarata R., Brown A. E., Armstrong D. Mycobacterium avium complex infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1986 Aug;105(2):184–188. doi: 10.7326/0003-4819-105-2-184. [DOI] [PubMed] [Google Scholar]
  11. Horsburgh C. R., Jr, Havlik J. A., Ellis D. A., Kennedy E., Fann S. A., Dubois R. E., Thompson S. E. Survival of patients with acquired immune deficiency syndrome and disseminated Mycobacterium avium complex infection with and without antimycobacterial chemotherapy. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):557–559. doi: 10.1164/ajrccm/144.3_Pt_1.557. [DOI] [PubMed] [Google Scholar]
  12. Horsburgh C. R., Jr Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991 May 9;324(19):1332–1338. doi: 10.1056/NEJM199105093241906. [DOI] [PubMed] [Google Scholar]
  13. Hoy J., Mijch A., Sandland M., Grayson L., Lucas R., Dwyer B. Quadruple-drug therapy for Mycobacterium avium-intracellulare bacteremia in AIDS patients. J Infect Dis. 1990 Apr;161(4):801–805. doi: 10.1093/infdis/161.4.801. [DOI] [PubMed] [Google Scholar]
  14. Jacobson M. A., Hopewell P. C., Yajko D. M., Hadley W. K., Lazarus E., Mohanty P. K., Modin G. W., Feigal D. W., Cusick P. S., Sande M. A. Natural history of disseminated Mycobacterium avium complex infection in AIDS. J Infect Dis. 1991 Nov;164(5):994–998. doi: 10.1093/infdis/164.5.994. [DOI] [PubMed] [Google Scholar]
  15. Jordan T. J., Lewit E. M., Montgomery R. L., Reichman L. B. Isoniazid as preventive therapy in HIV-infected intravenous drug abusers. A decision analysis. JAMA. 1991 Jun 12;265(22):2987–2991. [PubMed] [Google Scholar]
  16. Kemper C. A., Meng T. C., Nussbaum J., Chiu J., Feigal D. F., Bartok A. E., Leedom J. M., Tilles J. G., Deresinski S. C., McCutchan J. A. Treatment of Mycobacterium avium complex bacteremia in AIDS with a four-drug oral regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. The California Collaborative Treatment Group. Ann Intern Med. 1992 Mar 15;116(6):466–472. doi: 10.7326/0003-4819-116-6-466. [DOI] [PubMed] [Google Scholar]
  17. Kerlikowske K. M., Katz M. H., Chan A. K., Perez-Stable E. J. Antimycobacterial therapy for disseminated Mycobacterium avium complex infection in patients with acquired immunodeficiency syndrome. Arch Intern Med. 1992 Apr;152(4):813–817. [PubMed] [Google Scholar]
  18. Kirschner R. A., Jr, Parker B. C., Falkinham J. O., 3rd Epidemiology of infection by nontuberculous mycobacteria. Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum in acid, brown-water swamps of the southeastern United States and their association with environmental variables. Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):271–275. doi: 10.1164/ajrccm/145.2_Pt_1.271. [DOI] [PubMed] [Google Scholar]
  19. Long R., Scalcini M., Manfreda J., Jean-Baptiste M., Hershfield E. The impact of HIV on the usefulness of sputum smears for the diagnosis of tuberculosis. Am J Public Health. 1991 Oct;81(10):1326–1328. doi: 10.2105/ajph.81.10.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Northfelt D. W., Mayer A., Kaplan L. D., Abrams D. I., Hadley W. K., Yajko D. M., Herndier B. G. The usefulness of diagnostic bone marrow examination in patients with human immunodeficiency virus (HIV) infection. J Acquir Immune Defic Syndr. 1991;4(7):659–666. [PubMed] [Google Scholar]
  21. Sathe S. S., Gascon P., Lo W., Pinto R., Reichman L. B., Gascone P. Severe anemia is an important negative predictor for survival with disseminated Mycobacterium avium-intracellulare in acquired immunodeficiency syndrome. Am Rev Respir Dis. 1990 Dec;142(6 Pt 1):1306–1312. doi: 10.1164/ajrccm/142.6_Pt_1.1306. [DOI] [PubMed] [Google Scholar]
  22. Schneiderman D. J., Arenson D. M., Cello J. P., Margaretten W., Weber T. E. Hepatic disease in patients with the acquired immune deficiency syndrome (AIDS). Hepatology. 1987 Sep-Oct;7(5):925–930. doi: 10.1002/hep.1840070522. [DOI] [PubMed] [Google Scholar]
  23. Selwyn P. A., Hartel D., Lewis V. A., Schoenbaum E. E., Vermund S. H., Klein R. S., Walker A. T., Friedland G. H. A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med. 1989 Mar 2;320(9):545–550. doi: 10.1056/NEJM198903023200901. [DOI] [PubMed] [Google Scholar]
  24. Small P. M., Schecter G. F., Goodman P. C., Sande M. A., Chaisson R. E., Hopewell P. C. Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. N Engl J Med. 1991 Jan 31;324(5):289–294. doi: 10.1056/NEJM199101313240503. [DOI] [PubMed] [Google Scholar]
  25. Snider D. E., Jr, Cauthen G. M., Farer L. S., Kelly G. D., Kilburn J. O., Good R. C., Dooley S. W. Drug-resistant tuberculosis. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):732–732. doi: 10.1164/ajrccm/144.3_Pt_1.732. [DOI] [PubMed] [Google Scholar]
  26. Theuer C. P., Hopewell P. C., Elias D., Schecter G. F., Rutherford G. W., Chaisson R. E. Human immunodeficiency virus infection in tuberculosis patients. J Infect Dis. 1990 Jul;162(1):8–12. doi: 10.1093/infdis/162.1.8. [DOI] [PubMed] [Google Scholar]
  27. Yagupsky P., Menegus M. A. Cumulative positivity rates of multiple blood cultures for Mycobacterium avium-intracellulare and Cryptococcus neoformans in patients with the acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1990 Sep;114(9):923–925. [PubMed] [Google Scholar]
  28. Young L. S. Mycobacterium avium complex infection. J Infect Dis. 1988 May;157(5):863–867. doi: 10.1093/infdis/157.5.863. [DOI] [PubMed] [Google Scholar]
  29. Young L. S., Wiviott L., Wu M., Kolonoski P., Bolan R., Inderlied C. B. Azithromycin for treatment of Mycobacterium avium-intracellulare complex infection in patients with AIDS. Lancet. 1991 Nov 2;338(8775):1107–1109. doi: 10.1016/0140-6736(91)91965-w. [DOI] [PubMed] [Google Scholar]

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