Protection from Mycobacterium avium complex disease in human immunodeficiency virus-infected persons with a history of tuberculosis

J Infect Dis. 1996 Dec;174(6):1212-7. doi: 10.1093/infdis/174.6.1212.

Abstract

Risk of Mycobacterium avium complex disease was examined in human immunodeficiency virus (HIV)-infected patients with and without a history of tuberculosis. Information was obtained by retrospective review of charts of patients in HIV clinics in 10 US cities. Among 1363 patients with <200 CD4 cells/mm3 seen at Grady Memorial Hospital (GMH), 11 (17%) of 66 with a history of a positive purified protein derivative (PPD) skin test acquired M. avium infection, while 29 (16%) of 185 who were PPD-negative (but not anergic) did not (P = .85). Only 4 (8%) of 49 GMH patients with a history of tuberculosis acquired M. avium infection compared with 252 (19%) of 1314 GMH patients without a history of tuberculosis (P = .05). Proportional hazards analysis of risk factors for M. avium infection among 441 persons with and 8702 persons without a history of tuberculosis in 9 other cities confirmed protection from M. avium infection in persons with a history of tuberculosis (relative risk, 0.52; 95% confidence interval, 0.36-0.76; P < .001). Prior tuberculosis provides protection against M. avium infection in HIV-infected persons, possibly by stimulation of antimycobacterial immunity.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • CD4 Lymphocyte Count
  • Female
  • HIV Infections / complications*
  • Humans
  • Immune Tolerance
  • Immunity, Active
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Mycobacterium avium-intracellulare Infection / complications*
  • Mycobacterium avium-intracellulare Infection / immunology
  • Mycobacterium avium-intracellulare Infection / prevention & control*
  • Retrospective Studies
  • Risk Factors
  • Tuberculin Test
  • Tuberculosis / complications*