Mycobacterium tuberculosis infection and disease are not associated with protection against subsequent disseminated M. avium complex disease.

摘要: Objective: To determine the relationship between Mycobacterium tuberculosis infection and disease subsequent disseminated M. avium complex (MAC) in HIV-infected persons. Design: A prospective observational cohort study. Setting: The AIDS Linked to Intravenous Experience (ALIVE) of injecting drug users Johns Hopkins Hospital Adult HIV Clinic (JHHAHC). Participants: persons aged > 18 years with CD4 lymphocytes < 100 × 10 6 /l were followed July 1989 31 October 1996. There 182 ALIVE 1129 JHHAHC who met these criteria. Main outcome measure: relative risk MAC was determined according a history prior opportunistic infection, prophylaxis, antiretroviral therapy, or disease, race, sex, use. Results: Amongst 30 patients active tuberculosis, eight developed MAC, compared 208 cases amongst 1148 without [relative (RR), 1.5; 95% confidence interval (Cl), 0.8-2.7; P = 0.2]. extrapulmonary five (RR, 2.8; Cl, 1.5-5.2; 0.02). Injecting use associated decreased 0.7; 0.6-0.9; 0.007). In logistic regression analysis, significantly other whereas antibiotic prophylaxis protective. Conclusions: not protection against However, at increased for particularly low cell levels.