PREVENTIVE ANTIBIOTICS GREATLY REDUCE INCIDENCE OF MYCOBACTERIUM AVIUM INFECTION IN AIDS PATIENTS

February 1997

Media Contacts: Sarah Goodwin, 404/727-3366 - sgoodwi@emory.edu
Holly Korschun, 404/727-3990 -- hkorsch@emory.edu
Kathi Ovnic, 404/727-9371 - covnic@emory.edu
http://www.emory.edu/WHSC/

CHICAGO -- AIDS patients treated with preventive antibiotics (primary prophylaxis) have had a greatly reduced incidence of infection with disseminated Mycobacterium avium complex (DMAC), one of several opportunistic diseases common worldwide in patients with AIDS and the most common bacterial infection in people with HIV in the U.S.

David Rimland, M.D., Emory University professor of medicine and director of the Georgia Research Center on AIDS and HIV Infection, studied 1,600 AIDS patients treated at the Atlanta Veterans Affairs Medical Center between 1984 and 1997. The incidence of DMAC in patients most at risk (those with CD4+ t-cell counts below 200) declined sharply after the introduction of prophylactic therapy with two antibiotics - rifabutin in late 1994 and azithromycin in 1996.

Results of the VA-funded study were presented at the 5th Conference on Retroviruses and Opportunistic Infections in Chicago Feb. 1-5.

Between 1984 and 1997, 184 cases of DMAC were diagnosed within the VA study group. The incidence of DMAC increased steadily from 2.6 cases per 100 patients at risk in 1987 to a peak of 11.6 cases per 100 patients at risk in 1994, probably due to improvements in diagnosis and to an increase in infections due to longer survival, according to Rimland. After the introduction of the prophylactic therapy, the incidence of DMAC declined sharply to 3.2 cases per 100 in 1996 and to 1.0 cases per 100 in 1997.

Of the 30 cases of DMAC diagnosed in the study group since the availability of the prophylactic therapy, Dr. Rimland found several causes of failure, including lack of data on CD4 counts, refusal of therapy, and drug resistance. DMAC, which often disseminates (spreads throughout the body) in AIDS patients, significantly reduces the length and quality of life, causing weight loss, fatigue, diarrhea, poor appetite and anemia.

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