"The risks versus benefits must be carefully evaluated. We want to protect patients from MAC, but we also want to prevent them from developing resistance to antibiotics," said Aberg, who is a UCSF assistant professor of medicine and also treats patients at San Francisco General.
In the pre-HAART era, macrolides were standard treatment as prevention therapy against MAC infection in AIDS patients whose CD4+ counts were below 75, according to Aberg. Now with HAART, many patients may have CD4+ counts that are higher.
The main conclusion from study findings, she said, is that careful consideration should be given to continuing use of macrolides for MAC prophylaxis when CD4+ counts have increased and to using macrolides for infection treatment if a patient has been on a macrolide previously.
Both research studies were supported by grants from the NIH UCSF Center for AIDS Research and the UC Universitywide AIDS Research Program,
In addition, the CMV retinitis study received a grant from Research to Prevent Blindness, Inc., and the macrolide bacterial resistance study received support from Abbott Laboratories.