Mycobacterium-avium complex.

The ubiquitous MAC causes disseminated disease in a large proportion of patients with AIDS. It will become an increasingly important clinical pathogen as more patients survive within the context of prolonged immunodeficiency. The primary risk factor for DMAC is CD4 < 100 mm3 and thus the institution of adequate prophylaxis will significantly reduce its presentation in advanced HIV infection. For those patients presenting with DMAC, therapy with a multiple drug regimen including a macrolide is indicated. Because of potential toxicities and interactions in these debilitated patients, however, the ideal approach is to employ a minimum number of drugs with maximal clinical activity.