PROINFLAMMATORY CYTOKINE AND HUMAN-IMMUNODEFICIENCY-VIRUS RNA LEVELS DURING EARLY MYCOBACTERIUM-AVIUM COMPLEX BACTEREMIA IN ADVANCED AIDS

The relationship between Mycobacterium avium complex (MAC) bacteremia and proinflammatory cytokine and human immunodeficiency virus type 1 ( HIV-1) RNA levels in AIDS was investigated. During a prospective study , blood samples were drawn monthly for mycobacterial cultures. Sera we re available at baseline and onset of MAC bacteremia from 20 cases and at corresponding times from 19 controls. Mean interleukin-6 (IL-6) le vels were 154% greater at the time of MAC bacteremia in cases than in controls. The IL-6 levels correlated with body temperature, serum tumo r necrosis factor (TNF-alpha) levels, and alkaline phosphatase Levels (P less than or equal to .004 for each). Although TNF-alpha levels ten ded to rise more in MAC patients than in controls, the difference was not significant. However, among both cases and controls, serum TNF-alp ha levels rose significantly from baseline to the time of last sample, irrespective of MAC infection (P = .015). Bacteremia was not associat ed with increased serum HIV-1 RNA levels, Thus, early MAC bacteremia i s associated with increases in serum lL-6 levels, while TNF-alpha leve ls rise over time during advanced AIDS.