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Predictors of survival and eradication of Mycobacterium avium complex bacteremia ( MAC ) in AIDS patients in the Canadian randomized MAC treatment trial . Canadian HIV Trials Network Protocol 010 Study Group . OBJECTIVE To assess the importance of baseline characteristics including medical history , indicators of current disease status , therapeutic drug use , in vitro drug susceptibility , immune status and mycobacterial load on bacteriologic response and survival in HIV-positive patients with Mycobacterium avium complex ( MAC ) bacteremia . DESIGN An observational substudy of an open-label randomized controlled trial of two alternative therapeutic regimens for MAC . SETTING Twenty-four hospital-based HIV clinics in 16 Canadian cities . MAIN OUTCOME MEASURES The main outcome measures were survival and bacteriologic response , defined by consecutive negative blood cultures for MAC at least 2 weeks apart within 16 weeks of study entry . RESULTS Prior AIDS diagnosis , low Karnofsky score , active unstable AIDS-related conditions , absence of antiretroviral therapy and absence of Pneumocystis carinii pneumonia prophylaxis were associated with shorter survival by univariate regression using the proportional hazards model . On multivariate analysis , antiretroviral therapy was not an independent predictor of mortality , and previous rifabutin prophylaxis was independently associated with poor survival outcomes , a result consistent across study treatment . Using a logistic regression model , baseline quantitative mycobacterial load [ relative odds of clearing , 1.97 for a decrease of 1 log10 colony forming count ; 95 % confidence interval ( CI ) , 1.36-2.87 ; P < 0.001 ] and Karnofsky score were the only statistically significant univariate predictors of clearance , although previous prophylaxis with rifabutin was also a significant predictor in a multivariate model ( relative odds of clearing , 0.39 ; 95 % CI , 0.17-0.88 ; P < 0.05 ) . CONCLUSIONS This study indicates that although the level of MAC bacteremia is an important predictor of clearance , it is not associated with survival .
616
Intervention_Pharmacological
therapeutic regimens
617
Outcome_Physical
indicators of current disease status
618
Outcome_Physical
therapeutic drug use
619
Outcome_Physical
in vitro drug susceptibility
620
Outcome_Physical
immune status
621
Outcome_Physical
mycobacterial load
622
Outcome_Physical
bacteriologic response
623
Outcome_Mortality
survival
624
Outcome_Mortality
survival
625
Outcome_Physical
bacteriologic response
626
Outcome_Mortality
survival
627
Outcome_Mortality
mortality
628
Outcome_Physical
baseline quantitative mycobacterial load
629
Outcome_Physical
Karnofsky score
630
Participant_Condition
AIDS
631
Participant_Condition
HIV-positive
632
Participant_Condition
Mycobacterium avium complex ( MAC ) bacteremia
633
Participant_Sample-size
Twenty-four