Effects of Mycobacterium avium complex-infection treatment on cytokine expression in human immunodeficiency virus-infected persons: Results of AIDS Clinical Trials Group Protocol 853

Human immunodeficiency virus (HIV) type 1-infected persons with newly diagn osed Mycobacterium avium complex (MAC) bacteremia were enrolled in an 8-wee k study to determine whether treatment of MAC infection is associated with decreases in plasma tumor necrosis factor (TNF)-alpha levels. Blood specime ns were obtained for quantitative MAC cultures and to determine plasma leve ls of HIV RNA, TNF-alpha, and other proinflammatory cytokines. MAC levels d ecreased by 1.75 log at week 4 (P = .008) and by 2.48 log at week 8 (P = .0 01). Plasma TNF-alpha decreased by 0.15 log at week 4 (P = .042) and by 0.4 0 log at week 8 (P = .027). Plasma interleukin (IL)-6 decreased by 0.56 log at week 8 (P = .039). There were nonsignificant trends (P < .10) for plasm a levels of IL-1 beta and HIV RNA to decrease at week 8. Nonsignificant dec reases in plasma levels of TNF-alpha, IL-1 beta, IL-6, and HIV RNA were als o seen in those individuals who remained on stable antiretroviral therapy t hroughout the 8 weeks of the study.