HUMAN-IMMUNODEFICIENCY-VIRUS REPLICATION IN AIDS PATIENTS WITH MYCOBACTERIUM-AVIUM COMPLEX BACTEREMIA - A CASE-CONTROL STUDY

The development of opportunistic infections and the administration of vaccines have been associated with transient increases of human immuno deficiency virus (HIV) RNA plasma levels in HIV-infected patients. To determine the relationship between Mycobacterium avium complex (MAC) b acteremia and HIV RNA levels, HIV RNA levels in patients who developed MAC bacteremia (cases) were compared with levels in patients who rema ined free of MAC disease (controls). Cases and controls were matched f or CD4 cell count, prophylaxis against MAC disease, antiretroviral the rapy, and duration of follow-up. Mean baseline HIV RNA levels were 4.8 log(10) copies/mL in cases and 4.6 log(10) copies/ml in controls (P = 0.22). HIV RNA levels increased by a median of 0.4 log in cases but n ot controls at the time of MAC bacteremia (P = 0.01). In AIDS patients , the onset of MAC bacteremia is associated with a modest but signific ant increase in serum HIV RNA levels. Increased HIV replication may co ntribute to the higher mortality associated with MAC bacteremia.