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Sequencing of Bacterial Microflora in Peripheral Blood: our Experience with HIV-infected Patients
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Published on: June 11, 2011

Gastro-intestinal involvement in Mycobacterium avium-intracellulare infection of patients with HIV

T J Hellyer1, I N Brown, M B Taylor

  • 1Department of Medical Microbiology, St Mary's Hospital Medical School, London, U.K.

The Journal of Infection
|January 1, 1993
PubMed

Insights

Mycobacterium avium-intracellulare (MAI) is frequently found in the faeces of patients with AIDS, suggesting the gastro-intestinal tract is a key entry point. Faecal cultures can aid in early diagnosis of MAI infection in late-stage HIV disease.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Immunology

Background:

  • Mycobacterium avium-intracellulare (MAI) is an opportunistic pathogen.
  • MAI infections are common in individuals with advanced Human Immunodeficiency Virus (HIV) infection.
  • The gastro-intestinal tract's role in MAI infection requires further elucidation.

Purpose of the Study:

  • To investigate the prevalence of MAI in faecal specimens of HIV-infected individuals.
  • To determine the correlation between MAI faecal shedding and disease progression in HIV patients.
  • To assess the utility of faecal cultures for diagnosing MAI in the context of HIV.

Main Methods:

  • Analysis of 866 faecal specimens from 437 individuals.
  • Categorization of participants into HIV seronegative, asymptomatic HIV seropositive, symptomatic HIV infection, and Acquired Immunodeficiency Syndrome (AIDS) groups.
  • Isolation and identification of Mycobacterium avium-intracellulare (MAI).

Main Results:

  • MAI was isolated from 14.8% of patients with AIDS.
  • MAI was detected in 1.3% of patients with symptomatic HIV infection.
  • No MAI was found in HIV seronegative or asymptomatic HIV seropositive individuals.
  • Positive faecal cultures strongly correlated with disseminated MAI disease.

Conclusions:

  • The gastro-intestinal tract is a likely portal of entry for MAI.
  • MAI infection is indicative of late-stage HIV disease.
  • Faecal cultures are recommended for the early diagnosis of MAI in HIV-infected patients.

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