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[Mycobacterial infections in AIDS]
1Service des maladies infectieuses et tropicales, Hôpital Raymond-Poincaré, Garches.
Mycobacterial infections are the main cause of bacterial infections during HIV infection. The HIV infection epidemic contributed to the worldwide resurgence of the tuberculous endemic. The clinical presentation of tuberculosis is often atypical and extrapulmonary. The general guidelines for treatment are not modified, but HIV infection often worsens the tolerance of treatment. A poor compliance to treatment is the main cause of relapse or of selection of resistant mutants. The two main points for the control of tuberculosis in the era of HIV are a free access of patients to antituberculosis drugs, and a surveillance of the compliance until treatment is completed. Atypical mycobacteria, mainly represented by Mycobacterium avium, are bacteria from the environment, poorly virulent, responsible for infections occurring late in the course of AIDS. Current treatments use combinations including clarithromycin.
Mycobacterial infections are the main cause of bacterial infections during HIV infection. The HIV infection epidemic contributed to the worldwide resurgence of the tuberculous endemic. The clinical presentation of tuberculosis is often atypical and extrapulmonary. The general guidelines for treatment are not modified, but HIV infection often worsens the tolerance of treatment. A poor compliance to treatment is the main cause of relapse or of selection of resistant mutants. The two main points for the control of tuberculosis in the era of HIV are a free access of patients to antituberculosis drugs, and a surveillance of the compliance until treatment is completed. Atypical mycobacteria, mainly represented by Mycobacterium avium, are bacteria from the environment, poorly virulent, responsible for infections occurring late in the course of AIDS. Current treatments use combinations including clarithromycin.