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Mycobacterial Diseases in HIV-Positive Patients

Department of Medicine, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106.

Mycobacterial infections comprise the largest group of opportunistic infections in the HIV-infected population. The incidence of these and other opportunistic infections has declined significantly since the introduction of highly active antiretroviral therapy. Mortality from these illnesses has decreased as optimal combinations of antibiotics were discovered. Despite these facts, mycobacterial infections still pose a major threat to AIDS patients, particularly in underserved populations. The most common mycobacterial infections found in HIV-infected individuals are Mycobacterium tuberculosis, Mycobacterium avium intracellulare, and Mycobacterium kansasii, although other nontuberculous mycobacteria have been isolated. While established guidelines have made the task of preventing and treating opportunistic infections easier, resistance, toxicity, adherence, and drug interactions remain barriers to providing optimal therapy.

Key Words: Mycobacterium • tuberculosis • prophylaxis • immune reconstitution • opportunistic infection

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