ICAAC highlight: MAC prophylaxis can be safely discontinued in HIV-infected,,patients who respond to HAART

icant differences in the rate of MAC infection between the two arms. Two MAC infections occurred in the placebo group and none in the azithromycin group. Both cases of MAC infection were unusual, being localized to bone and masses along the spine; infection was not found in the blood.

The study investigators say HAART by itself appears to be remarkably successful in preventing the occurrence of MAC. They conclude that the study provides strong evidence indicating that prophylactic therapy for MAC may be safely withdrawn in persons who achieve this degree of response to HAART and maintain CD4+ T-cell counts greater than 50. Also, MAC infection occurring in these patients may be localized and have unusual signs and symptoms.

Another NIAID-supported clinical network, the Community Programs for Clinical Research on AIDS (CPCRA), is currently conducting a similar study. This study, known as CPCRA 048, is chaired by Wafaa El-Sadr, M.D., M.P.H., of Harlem Hospital in New York City. This ongoing study is comparing azithromycin with placebo for preventing MAC and bacterial pneumonia among patients with significant rebound in CD4+ T-cell count. Interim results are similar to the findings of the ACTG study.


Contact: Laurie K. Doepel
NIH/National Institute of Allergy and Infectious Diseases

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