Clinical
Features |
Several different syndromes are
caused by Mycobacterium avium complex (MAC). Disseminated
infections are usually associated with HIV infection. Less
commonly, pulmonary disease in nonimmunocompromised persons
is a result of infection with MAC. In children, the most common
syndrome is cervical lymphadenitis. |
Etiologic
Agent |
Mycobacterium avium complex
(comprising M. avium and M.intracellulare).
|
Incidence |
Not reportable. Population-based
data available for Houston and Atlanta metropolitan areas
suggest a rate of 1/100,000/year. Incidence is decreasing
among HIV- infected patients as a result of new treatment
modalities e.g., combination therapy with nucleoside reverse
transcriptase inhibitors and protease inhibitors, as well
as antimycobacterial prophylaxis. |
Sequelae |
In HIV infected persons, manifestations
include night sweats, weight loss, abdominal pain, fatigue,
diarrhea, and anemia. |
Transmission |
Although the mode of transmission
is unclear, MAC is most likely environmentally acquired. |
Risk
Groups |
HIV-infected persons. Rarely in
children or nonimmuno-compromised persons. |
Surveillance |
MAC is not nationally reportable.
Currently under active surveillance in the Houston and Atlanta
metropolitan areas. |
Trends |
Incidence is decreasing because
of changes in treatment for HIV-infected patients; however,
antimicrobial resistance may be increasing. |
Challenges |
Antimicrobial resistance and better
treatment for affected persons. Unclear knowledge of acquisition
of MAC from the environment. |
Opportunities |
Reduction in MAC infection as a
significant cause of morbidity and mortality in HIV-infected
patients as a result of changes in available therapies. |
|
December 2002
|