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The objectives of this study were to assess whether culture conversion affects quality of life (QoL), survival and Mycobacterium avium complex (MAC)-associated morbidity in patients with AIDS. Data from an open, multicenter, noncomparative trial were analyzed to test the benefit of suppressing mycobacteria: measures of QoL, clinical outcomes and quality-adjusted survival are compared on occasion of culture-negative and positive assessments. The study was conducted at AIDS clinics in France, coordinated by the GETIM, with the participation of 51 AIDS patients with culture-proven Non-Tuberculous Mycobacteria (NTM) disease. Patients underwent a quadruple drug-regimen. The following parameters were investigated: (i) Culture conversion to a negative finding (= suppression) or on > 2 occasions, including each patient's last valid observation (= conversion); (ii) survival after treatment start; (iii) QoL by using the ECOG score, re-coded 0 to 4 for worst to best performance status; (iv) quality-adjusted survival. On treatment, > 1 negative culture was recorded for 69% of the evaluable patients, corresponding to 111 person-months of observation. Positive culture findings accounted for 42 person-months only. Patients' performance status (mean 1.8 at entry) worsened or improved according to whether culture was positive or negative (means 1.2 and 2.2; total scores 109 and 217 person-months, respectively). Similarly, MAC-attributable morbidity was significantly reduced when culture was negative. Mean survival was 195 days longer in treatment success patients. These analyses suggest that, in patients with NTM disease occurring as a late complication of AIDS, treatment was effective in improving clinical status and survival, and in suppressing bacterial growth.(ABSTRACT TRUNCATED AT 250 WORDS)

Original publication

DOI

10.1080/1120009x.1994.11741151

Type

Journal

Journal of chemotherapy (Florence, Italy)

Publication Date

06/1994

Volume

6

Pages

189 - 196

Addresses

R&D/Anti-infectives, Farmitalia Carlo Erba, Milan, Italy.

Keywords

Humans, Mycobacterium avium Complex, Mycobacterium avium-intracellulare Infection, AIDS-Related Opportunistic Infections, Ethambutol, Isoniazid, Clofazimine, Rifabutin, Drug Therapy, Combination, Microbial Sensitivity Tests, Prospective Studies, Body Burden, Quality of Life, Adult, Aged, Middle Aged, Male