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Original ArticleOpen Access
Mycobacterium A vium Complex in HIV -infected Thai Children
Phongsamart W 
,
Chokephaibulkit K ,
Chaiprasert A ,
Vanprapa N ,
Chearskul S ,
Lokekha R
,
Chokephaibulkit K ,
Chaiprasert A ,
Vanprapa N ,
Chearskul S ,
Lokekha R KULKANYA CHOKEPHAIBULKIT, M.D.*,
NIRUN VANPRAPA,M.D.*,
RANGSIMA LOLEKHA, M.D.*
Of the 169 human immunodeficiency virus (HIV)-infected children being cared for at Siriraj
Hospital from January 1998 to September 2000, 10 had
Mycobacterium avium
complex (MAC)
infection; seven had disseminated disease and three had MAC pneumonia. Nine children were in the
advanced stage of HIV disease at the time of diagnosis with the median CD4 count of 7 cells/mm3
and 127 cells/mm
3
and the median age of 65 months and 63 months in disseminated MAC and MAC
pneumonia respectively. None of these children had received prior chemoprophylaxis.
Common clinical findings included prolonged fever, weight loss, lymphadenopathy, hepato-
splenomegaly, diarrhea, anemia and leukopenia. The outcome of MAC infection was poor, with a
mortality rate of 60 per cent. In
in vitro
susceptibility testing, clarithromycin was the least resistant
drug.
With the incidence rate of 2.15 per 100 person-years, the high rate of antimicrobial resis-
tance, and the poor outcome, primary chemoprophylaxis for MAC infection in conjunction with
effective antiretroviral therapy should be considered for Thai children in the advanced stage of
HIV infection.
Key word :
Mycobacterium Avium
Complex, MAC, HIV-Infected Children, Chemoprophylaxis
NIRUN VANPRAPA,M.D.*,
RANGSIMA LOLEKHA, M.D.*
Of the 169 human immunodeficiency virus (HIV)-infected children being cared for at Siriraj
Hospital from January 1998 to September 2000, 10 had
Mycobacterium avium
complex (MAC)
infection; seven had disseminated disease and three had MAC pneumonia. Nine children were in the
advanced stage of HIV disease at the time of diagnosis with the median CD4 count of 7 cells/mm3
and 127 cells/mm
3
and the median age of 65 months and 63 months in disseminated MAC and MAC
pneumonia respectively. None of these children had received prior chemoprophylaxis.
Common clinical findings included prolonged fever, weight loss, lymphadenopathy, hepato-
splenomegaly, diarrhea, anemia and leukopenia. The outcome of MAC infection was poor, with a
mortality rate of 60 per cent. In
in vitro
susceptibility testing, clarithromycin was the least resistant
drug.
With the incidence rate of 2.15 per 100 person-years, the high rate of antimicrobial resis-
tance, and the poor outcome, primary chemoprophylaxis for MAC infection in conjunction with
effective antiretroviral therapy should be considered for Thai children in the advanced stage of
HIV infection.
Key word :
Mycobacterium Avium
Complex, MAC, HIV-Infected Children, Chemoprophylaxis
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