Havlir D V
Department of Internal Medicine, University of California, San Diego 92103, USA.
Eur J Clin Microbiol Infect Dis. 1994 Nov;13(11):915-24. doi: 10.1007/BF02111492.
Disseminated Mycobacterium avium complex (MAC) is one of the most common opportunistic infections in AIDS patients and is increasingly recognized as a significant pathogen in chronic pulmonary disease in nonimmunocompromised patients. Important progress in therapy has occurred over the last several years. In AIDS patients, multidrug therapy has been shown to be beneficial in terms of reducing circulating bacteremia and improving clinical symptoms. Clarithromycin and azithromycin, two broad-spectrum antimicrobials with minimal activity against Mycobacterium tuberculosis, have emerged as potent, well tolerated agents pivotal to treatment regimens. In AIDS patients, rifabutin prophylaxis reduced the frequency of MAC bacteremia by 50% in two placebo controlled trials. Despite these advances, there remains a need for determining the optimal combination regimens for therapy, and more effective drugs for prophylaxis which are beneficial both in terms of survival and functional capacity of patients.
播散性鸟分枝杆菌复合体（MAC）感染是艾滋病患者最常见的机会性感染之一，并且越来越被认为是免疫功能正常患者慢性肺病的重要病原体。在过去几年中，治疗方面取得了重要进展。在艾滋病患者中，多药联合治疗已显示出在减少循环菌血症和改善临床症状方面有益。克拉霉素和阿奇霉素这两种对结核分枝杆菌活性极小的广谱抗菌药物，已成为治疗方案中关键的强效且耐受性良好的药物。在两项安慰剂对照试验中，艾滋病患者使用利福布汀预防可使MAC菌血症的发生率降低50%。尽管有这些进展，但仍需要确定最佳的联合治疗方案，以及更有效的预防性药物，这些药物在患者生存和功能能力方面都有益。
