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Prophylaxis Against Mycobacterium avium-intracellulare (MAI) complex Infection in HIV Patient

Purpose: To determine if a patient with HIV infection should receive chemoprophylaxis against Mycobacterium avium-intracellulare (MAI) complex.

Description

Infections due to Mycobacterium avium-intracellular complex (MAI or MAC) can be chronic and difficult to treat. A patient with HIV disease may require prophylaxis if CD4 lymphopenia develops, but this can be discontinued in some patients following highly active antiretroviral therapy (HAART).


Primary Prophylaxis

CD4 count

starting primary prophylaxis

< 50 per µL

discontinuing primary prophylaxis

> 100 per µL for >= 3 months

restarting primary prophylaxis

< 50 – 100 per µL

 

 

Secondary Prophylaxis

Criteria

starting primary prophylaxis

documented disseminated disease

discontinuing primary prophylaxis

(1) asymptomatic for MAC infection

(2) CD4 > 100 per µL for >= 6 months

(3) completed 12 months of MAC therapy

restarting primary prophylaxis

CD4 count < 100 per µL

 


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Specialty

Objective

ICD-10