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HIV, AIDS, and Mycobacterium Avium Complex

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Treating Mycobacterium Avium Complex

Even without a confirmed diagnosis, your doctor may treat you for MAC if your CD4 cell count goes below 50. You will likely receive a combination of antibiotics to prevent development of drug resistance. You may receive either clarithromycin or azithromycin and one to three other antibiotics. After the initial treatment to get the condition under control, you'll likely be given maintenance treatment, which typically lasts 12 months.

Here are drugs often used to treat MAC disease.

You should know that these drugs can interact with others and cause side effects. For this reason, be sure to tell your doctor about all the medications you are taking. MAC drugs may interact with:

  • Antiretroviral medications
  • Antifungal medications
  • Birth control pills
  • Blood thinning drugs

Because of problems with interactions, doctors sometimes recommend treating MAC before starting antiretroviral therapy.

These are some of the most common side effects of MAC medications.

  • Kidney problems; early signs include decreased urination, increased thirst, and lightheadedness
  • Nausea, vomiting, or diarrhea
  • Headaches
  • Eye swelling (uveitis), resulting in eye pain, light sensitivity, redness, or blurred vision
  • Rashes
  • Anemia
  • Fever or chills
  • Muscle or bone pain
  • Strange taste


Preventing Mycobacterium Avium Complex

Because MAC bacteria are so common, it isn't really possible to avoid exposure to them. Instead, the best ways to prevent MAC are to:

  • Take antiretroviral therapy.
  • Take MAC preventive medications, called prophylaxis, if your CD4 count falls below 50. You may take some of the same drugs as those used to treat MAC disease. Most commonly, clarithromycin and azithromycin are used for prevention.

Be sure to be tested for active infections of both MAC and TB before beginning any preventive therapy.

If you are able to keep your CD4 count above 100 for six months while on antiretroviral therapy, you may be able to stop MAC prophylaxis. You need to start preventive treatment again if your CD4 count goes back down.

WebMD Medical Reference

Reviewed by David T. Derrer, MD on August 17, 2014
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