Clinical and laboratory findings of disseminated Mycobacterium avium complex infection (DMAC) in a pair matched case-control study

Abstract

in order to define clinical and laboratory findings associated with DMAC infection in AIDS patients. Since DMAC infection is usually associated with advanced immunodeficiency, and therefore also with other opportunistic illnesses, in addition to the number of CD4 + lymphocytes, cases and controls were matched using the following criteria: date of AIDS diagnosis and antiretroviral therapy, number and severity of associated opportunistic infections and, whenever possible, type of Pneumocystis carinii prophylaxis, age and gender, in this order of relevance. Cases (defined as patients presenting at least one positive culture for MAC at a normally sterile site) and controls presented CD4 + lymphocyte counts below 50 cel/mm3. A significantly higher prevalence of general, digestive and respiratory signs, increased LDH levels, low hemoglobin levels and CD4 + cell counts were recorded for cases when compared to controls. Increases in γGT and alkaline phosphatase levels seen in cases were also recorded for controls. In conclusion, the strategy we used for selecting controls allowed us to detect laboratory findings associated to DMAC infection not found in other advanced immunosuppressed AIDS patients without DMAC.

Non-tuberculous mycobacteria in the sputum of HIV-infected patients: infection or colonization?

“…Haemoglobin levels were lower in the NTM disease group, probably indicating a chronic inflammatory anaemia or an NTM infection of the bone marrow (three patients had a positive culture from bone marrow). In case-control studies from the pre-HAART era, higher levels of gamma glutamyl transferase were found in patients with MAC infection suggesting a liver infiltration, 4,5 but in our study differences were not significant. A protracted clinical course with weight loss and symptoms for more than a month are useful indicators of an NTM infection if other diseases are excluded.…”