DISSEMINATED NONTUBERCULOUS IS MYCOBACTER IOSIS BY AIDS PATIENTS

Disseminated nontuberculous mycobacteriosis is a frequent and late com plication of HIV infection. All the 13 patients described here had CD4 -lymphocyte counts <20/mm(3). The causative agent was mainly M. avium complex. But we also found, for the first time, a double infection wit h M. avium complex and M. <<genavense>> and one patient with growth of M. shimoidei in the blood culture. Clinical signs are nonspecific (fe ver, reduced performance, anemia). Positive cultures of blood or tissu e biopsies are diagnostic. The therapeutic approach is the combination of new macrolides with other antimycobacterial agents. Prognosis is p oor, mainly due to advanced immunedeficiency, but two of our patients survived more than one year after diagnosis. Prophylactic treatment sh ould be considered in patients with CD4-counts less than 50/mm(3).