PMID- 17937815
OWN - NLM
STAT- MEDLINE
DCOM- 20080307
LR  - 20211020
IS  - 1479-5876 (Electronic)
IS  - 1479-5876 (Linking)
VI  - 5
DP  - 2007 Oct 15
TI  - Mycobacterium avium complex immune reconstitution inflammatory syndrome: long 
      term outcomes.
PG  - 50
AB  - BACKGROUND: To describe long term outcomes of Mycobacterium avium complex (MAC) 
      immune reconstitution inflammatory syndrome (IRIS). METHODS: Cases of MAC IRIS 
      were retrospectively identified at four HIV clinics (Michigan, Maryland, Rhode 
      Island, and Indiana) from 1996-2004. Patients were included if they were 
      initially diagnosed with AIDS and found to have evidence of focal MAC infection 
      documented by tissue culture or PCR after initiating HAART, and at least 6 months 
      of follow up. RESULTS: Among the 20 patients included, the mean age was 40 years, 
      mean CD4 cell count was 24/mm3 at pretreatment baseline and 100/mm3 at time of 
      MAC IRIS diagnosis. Sites of disease included lymph nodes (15 patients [8 
      peripheral, 8 abdominal and 1 peripheral and abdominal]), gastrointestinal tract 
      (7) and liver (3). Sixteen patients (80%) responded to treatment and were disease 
      free after a mean of 17.4 months of therapy for MAC IRIS; IRIS therapy was 
      withdrawn in 6 without relapse. Four patients (non-responder group) had 
      persistent or relapsing disease despite 27 months of ongoing MAC IRIS treatment. 
      At the time of resolution or last follow-up, the mean CD4 cell count and viral 
      load was 143/mm3 and 7,000 c/mL for responders, and 65/mm3 and 17,000 c/mL for 
      non-responders, respectively. Most patients with peripheral adenopathy were 
      responders (7/8; 88%); many with abdominal adenopathy (4/8; 50%) were 
      nonresponders. CONCLUSION: The majority of patients with MAC IRIS eventually 
      responded to treatment. Our sample size was not adequate to perform statistical 
      analysis, but there was a tendency towards adequate CD4 response to HAART and 
      peripheral rather than intraabdominal adenopathy among responders.
FAU - Riddell, James 4th
AU  - Riddell J 4th
AD  - Department of Internal Medicine, Division of Infectious Diseases, University of 
      Michigan Health System, Ann Arbor, Michigan, USA. jriddell@umich.edu
FAU - Kaul, Daniel R
AU  - Kaul DR
FAU - Karakousis, Petros C
AU  - Karakousis PC
FAU - Gallant, Joel E
AU  - Gallant JE
FAU - Mitty, Jennifer
AU  - Mitty J
FAU - Kazanjian, Powel H
AU  - Kazanjian PH
LA  - eng
PT  - Journal Article
DEP - 20071015
PL  - England
TA  - J Transl Med
JT  - Journal of translational medicine
JID - 101190741
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Abscess
MH  - Adult
MH  - Anti-Infective Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/complications
MH  - Humans
MH  - Inflammation/*microbiology
MH  - Lymph Nodes/microbiology/virology
MH  - Male
MH  - Middle Aged
MH  - Mycobacterium Infections/*metabolism
MH  - Mycobacterium avium/*metabolism
MH  - Syndrome
MH  - Treatment Outcome
PMC - PMC2213635
EDAT- 2007/10/17 09:00
MHDA- 2008/03/08 09:00
PMCR- 2007/10/15
CRDT- 2007/10/17 09:00
PHST- 2007/07/10 00:00 [received]
PHST- 2007/10/15 00:00 [accepted]
PHST- 2007/10/17 09:00 [pubmed]
PHST- 2008/03/08 09:00 [medline]
PHST- 2007/10/17 09:00 [entrez]
PHST- 2007/10/15 00:00 [pmc-release]
AID - 1479-5876-5-50 [pii]
AID - 10.1186/1479-5876-5-50 [doi]
PST - epublish
SO  - J Transl Med. 2007 Oct 15;5:50. doi: 10.1186/1479-5876-5-50.