Gilks C F, Brindle R J, Mwachari C, Batchelor B, Bwayo J, Kimari J, Arbeit R D, von Reyn C F
Clinical Research Centre, Kenya Medical Research Institute, Nairobi.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Feb 1;8(2):195-8.
Previous studies from Africa have been unable to identify disseminated Mycobacterium avium complex (MAC) infection in patients with advanced human immunodeficiency virus (HIV) infection. We performed mycobacterial blood cultures and CD4 counts on 48 symptomatic adults with advanced HIV infection admitted to the hospital in Nairobi, Kenya over 4 weeks in 1992. Fourteen patients had mycobacteremia; these patients had significantly lower CD4 counts than the patients with negative cultures (14/mm3 vs. 85/mm3; p < 0.01). Three patients (6%) were bacteremic with M. avium (mean CD4 count, 10/mm3) and 11 (23%) were bacteremic with Mycobacterium tuberculosis complex (MTB) (mean CD4 count, 15/mm3). Thus, M. avium bacteremia was detected significantly less frequently in the study population than MTB bacteremia (p = 0.04). The minimum rate for HIV-associated disseminated M. avium infection in patients admitted to the hospital in Nairobi was estimated to be approximately 1%. Patients with mycobacteremia died or were discharged home sick before the diagnosis was made. Disseminated M. avium does occur in adults with advanced HIV infection in sub-Saharan Africa, but is less common than disseminated MTB.
以往来自非洲的研究未能在晚期人类免疫缺陷病毒（HIV）感染患者中识别出播散性鸟分枝杆菌复合群（MAC）感染。1992年，我们在肯尼亚内罗毕对48名因晚期HIV感染出现症状而住院的成年患者进行了为期4周的分枝杆菌血培养和CD4细胞计数。14名患者出现分枝杆菌血症；这些患者的CD4细胞计数显著低于培养结果为阴性的患者（14/立方毫米对85/立方毫米；p<0.01）。3名患者（6%）血中检出鸟分枝杆菌（平均CD4细胞计数为10/立方毫米），11名患者（23%）血中检出结核分枝杆菌复合群（MTB）（平均CD4细胞计数为15/立方毫米）。因此，在研究人群中，鸟分枝杆菌血症的检出频率显著低于MTB血症（p = 0.04）。在内罗毕住院的患者中，与HIV相关的播散性鸟分枝杆菌感染的最低发生率估计约为1%。分枝杆菌血症患者在诊断前死亡或带病出院。播散性鸟分枝杆菌确实会在撒哈拉以南非洲的晚期HIV感染成人中出现，但比播散性MTB少见。
