COMPLIANCE TO PRIMARY PROPHYLAXIS FOR MYC OBACTERIUM-AVIUM-INTRACELLULARE IN ADVANCED HIV-INFECTION

The authors lead a study on compliance to primary MAC prophylaxis in p atients with advanced HIV infection, Ninety patients with CD4 cell cou nts below 100/mu l, received rifabutin (300 mg/d) in a primary prophyl axis trial for MAC bacteremia. Blood samples were randomly obtained an d rifabutin concentrations measured by high-performance liquid chromat ography. Fifty-nine blood samples from 41 patients (17 heterosexuals, 16 intravenous drug users, and 7 bisexual men) were assayed, Trough ri fabutin plasma levels were: above 20 mu g/l in 53 samples (89.8%) from 35 patients (85.4%); between 8 and 20 mu g/l in 2 samples (3.4%) from 2 patients (4.8%), and was absent in 4 samples (6.8%) from 4 patients (9.7%). On the day the blood sample was drawn, the mean number of med ical drugs per patient per day was 6 (range 3-13): anti-retroviral the rapy 1.27 (0-2), prophylactic regimen 3.27 (2-6), other treatments 1.5 3 (0-5), The mean numbers of pills per patient per day was 14.3 (4-30) : anti-retroviral 4.22 (0-10), prophylactic regimen 6.73 (3-21), other s 3.39 (0-12). We conclude that, in patients mainly heterosexuals and intravenous drug users - with advanced HIV-infection, prescribed treat ment regimen is usually well followed (over 85%). However these result s must be interpreted with caution since this study was carried out be fore bitherapy and protease inhibitors became standard therapy.