Low incidence of colonization and no cases of disseminated Mycobacterium avium complex infection (DMAC) in Brazilian AIDS patients in the HAART era

Abstract

The absence of DMAC infection in colonized individuals argues in favor of a HAART protective effect against; DMAC; however, restoration of CD(4) counts did not protect patients against MAC colonization.

The first ten years: achievements and challenges of the Brazilian program of universal access to HIV/AIDS comprehensive management and care, 1996-2006

“…Various papers 49,50 have documented a dramatic decline of Mycobacterium avium complex infection in the post-HAART era in Brazil, as reported elsewhere 51 . To a lesser extent, co-infections with Mycobacterium tuberculosis declined as well 52 , but remain as a major cause of morbidity and mortality of Brazilian AIDS patients 53 .…”

Mycobacterium avium restriction fragment lenght polymorphism-IS IS1245 and the simple double repetitive element polymerase chain reaction typing method to screen genetic diversity in Brazilian strains

“…However we suggest to strict its use in small sampling from select set because of the limitation on analysis of patterns with difference in one band. Despite HAART has dramatically decreased M. avium infections, it would be useful to have a simple and inexpensive genotypic method to easily screen a possible emergency of new genotype of M. avium among HIV patients with a change in their immunological status related to begging HAART (detection of a particular genotype in preexisting polyclonal infection) or when preexisting M. avium suppressive therapies or prophylaxis in patients on HAART are withdrawn (Legrand et al 2000) or to follow the epidemiological evolution in HAART patient that remains colonized by M. avium as showed by Gadelha et al (2002).…”

“…Protease inhibitors and non-nucleoside analogue reverse transcriptase inhibitors became available for clinical practice, and more recently the fusion inhibitors, as part of a combination regimen of a highly active antiretroviral treatment (HAART) (Carpenter et al 1996, Barbaro et al 2005. However, although has been reported decrease of disseminated MAC (DMAC) infection in colonized individu- als that argue in favor of a HAART protective effect against DMAC, restoration of CD4 counts seems not to protect patients against MAC colonization (Gadelha et al 2002).…”

Poor response to tuberculosis treatment with regimens without rifampicin in immunosuppressed AIDS patients

“…A prospective study was conducted at a hospital from September, 1997, to December, 1999, in order to evaluate mucosal colonization by mycobacteria and the incidence of disseminated mycobacterial disease in 79 immunosuppressed AIDS patients (a CD 4 count below 100 cell/mm 3 detected at least once) [8]. Sputum, stools and blood submitted to lysis centrifugation techniques were cultivated monthly in Lowënstein-Jansen media.…”