Revista: | The brazilian journal of infectious diseases |
Base de datos: | PERIÓDICA |
Número de sistema: | 000290741 |
ISSN: | 1413-8670 |
Autores: | Rolla, Valeria1 Gadelha, Angela2 Accacio, Naurea3 Grinzstejn, Beatriz Veloso, Valdilea Silveira, Liane Braga da Fandinho, Fatima Saad, Maria Helena Lourenco, Maria Cristina |
Instituciones: | 1Instituto Evandro Chagas, Rio de Janeiro. Brasil 2Fundacao Instituto Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro. Brasil 3Fundacao Instituto Oswaldo Cruz, Escola Nacional de Saude Publica, Rio de Janeiro. Brasil |
Año: | 2002 |
Periodo: | Oct |
Volumen: | 6 |
Número: | 5 |
Paginación: | 252-257 |
País: | Brasil |
Idioma: | Inglés |
Tipo de documento: | Artículo |
Enfoque: | Analítico, descriptivo |
Resumen en inglés | ABSTRACT OBJECTIVE: Evaluate the incidence of mycobacterial disease and the colonization of the respiratory and gastrointestinal tracts by Mycobacterium avium complex (MAC) bacteria in AIDS patients. METHODS: Inclusion criteria: HIV-positive individuals with at least one CD4+ count < 100 cells/mm3. Exclusion criteria: Mycobacterial disease and MAC prophylaxis. Stool, sputum, and blood cultures were prospectively obtained every month from September, 1997, to December, 1999. The incidence was calculated using Poisson regression. Survival was estimated by the Kaplan Meier method and the Cox proportional hazard model. RESULTS: We followed-up 79 patients during a median period of 428 days. Blood cultures (n = 742) were negative for all mycobacteria. Positive cultures (25 samples) were obtained from non-sterile sites: Stools (19/703 specimens = 2.7%) and sputum (14/742 specimens = 1.9%). MAC was isolated in 7/703 stool samples (1%) and 1/32 sputum specimens (0.1%). The incidence of patient colonization with MAC was 0.09 /year (CI=0.05 - 0.18). CD4 counts in patients colonized with MAC were below 100 cells/mm3 in only 2 out of 8 cases. Restoration of CD4+ counts >100 cells/mm3 (HR = 0.18; CI = 0.05 - 0.70) predicted a lower risk of death (P<0.05) but was not protective for MAC colonization (HR=0.52;CI =0.62 - 4.35, P=0.55). CONCLUSION: The absence of DMAC infection in colonized individuals argues in favor of a HAART protective effect against; DMAC; however, restoration of CD4 counts did not protect patients against MAC colonization |
Disciplinas: | Medicina |
Palabras clave: | Microbiología, Salud pública, Inmunología, Enfermedad micobacteriana, Colonización, Vías respiratorias, Vías gastrointestinales, Mycobacterium avium complex, SIDA |
Keyword: | Medicine, Microbiology, Public health, Mycobacterial disease, Colonization, Respiratory tract, Gastrointestinal tract, Mycobacterium avium complex, AIDS, Immunology |
Texto completo: | Texto completo (Ver HTML) |