Analysis of geographic risk was performed for Mycobacterium avium complex (MAC) bacteremia among North American patients with AIDS.
Monthly mycobacterial blood cultures were taken from patients who were placebo recipients in a prospective evaluation of MAC prophylaxis.
Of 571 patients, 102 (17.9%) acquired MAC bacteremia during an average follow-up of 256 days.
The area with the highest risk for MAC was the South Central region (27.9% ; P<0.02), whereas the area with the lowest risk was Canada (11.3% ; P=0.12).
When the southern states were combined and compared with the northern states and Canada, the incidence of MAC bacteremia was higher in the southern states (21.6% versus 14.0%, P<0.03).
Proportional hazards analysis was performed for the difference between the North and South and controlled for baseline CD4 cell count.
In this analysis, time to MAC was significantly longer in the North (hazard ratio=0.587,95% confidence interval 0.390 to 0.883, P=0.01).
Although overall variation in seasonality was not marked, there was a significant decrease in cases in the North during the summer months (P<0.01).
We conclude that geographic location is a risk factor for MAC bacteremia in patients with advanced AIDS, with decreased risk in northern North America.
Mots-clés Pascal : Mycobacterium avium, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bactérie, Facteur risque, Variation géographique, SIDA, Virose, Infection, Variation saisonnière, Evaluation, Exploration immunologique, Amérique du Nord, Amérique, Prospective, Homme, Mycobactériose, Bactériose, Environnement, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Mycobacterium avium, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bacteria, Risk factor, Geographical variation, AIDS, Viral disease, Infection, Seasonal variation, Evaluation, Immunological investigation, North America, America, Prospective, Human, Mycobacterial infection, Bacteriosis, Environment, Immunopathology, Immune deficiency
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0380996
Code Inist : 002B05B02O. Création : 12/09/1997.