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Nasty Infectious Diseases You Want To Avoid - Mycobacterium Avium Complex

Updated on December 31, 2008

The most common bacterial opportunistic infection in people with HIV, Mycobacterium avium complex (MAC) consists of two similar organisms: Mycobacterium avium and M. intracellulare. In one study, 43 percent of people with AIDS surviving two years after diagnosis tested positive for Mycobacterium avium complex, suggesting that the infection may be an almost inevitable complication of HIV infection. Mycobacterium avium complex is also sometimes called Mycobacterium avium intracellulare (MAI). Some studies have shown that Mycobacterium avium complex occurs more often in Caucasians than in Latinos and African Americans; homosexual and bisexual men may have a higher incidence of infection than those in other risk groups.

Cause - The Mycobacterium avium complex organisms are found commonly in water, water mists or vapors, dust, soil, and bird droppings. They usually enter the body via contaminated food and water, although they also can be inhaled into the lungs. Once inside the body, the organisms colonize and grow in the gastrointestinal tract or the lungs, where they don't usually cause any symptoms at first. Eventually, since they are not stopped by the body's normal response to infection, they attack the tissue lining the gut and reproduce tremendously. After a local infection, the Mycobacterium avium complex organisms usually enter the bloodstream and spread throughout the body.

Symptoms - The most common symptoms include fevers, night sweats, weight loss, loss of appetite, fatigue, or progressively severe diarrhea. Other symptoms include abdominal pain, nausea, and vomiting. Respiratory symptoms (cough and breathing problems) are fairly uncommon. However, painful joints, bone, brain, and skin infections can result when Mycobacterium avium complex bacteria spreads to other parts of the body.

Treatment - Since Mycobacterium avium complex bacteria are closely related to the organism that causes tuberculosis, some of the drugs used to treat TB are also used against Mycobacterium avium complex. While it is not clear if treating Mycobacterium avium complex prolongs survival, treatment definitely reduces symptoms and improves the quality of life. A dozen or more drugs are available to treat Mycobacterium avium complex; most experts agree that treating an advanced Mycobacterium avium complex infection requires several drugs because no drug is effective alone. Mycobacterium avium complex bacteria can quickly become resistant to a particular drug.

Prevention - Taking prophylactic drugs (such as rifabutin) can prevent or delay the onset of Mycobacterium avium complex in people with HIV infection. Since Mycobacterium avium complex organisms have been found in most city water systems, as well as hospital water supplies and bottled water, boiling drinking water is suggested. AIDS patients also are advised not to eat raw foods (especially salads, root vegetables, and unpasteurized milk or cheese). Conventional cooking (baking, boiling, or steaming) destroys Mycobacterium avium complex bacteria, which are killed at 176 degrees F. Fruits and vegetables should be peeled and rinsed thoroughly. Patients should avoid animal contact (especially birds and bird droppings). Pigeons, in particular, can transmit not just Mycobacterium avium complex but also the organism that causes cryptococcosis, another opportunistic infection found in people with HIV infection. Finally, HIV patients should avoid or reduce alcohol consumption, since regularly drinking alcohol can hasten the development of Mycobacterium avium complex infection in those with HIV.

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