MAC is also called MAI (Mycobacterium Avium Intracellulare). It is a slow-growing bacteria that gets inside cells in the body. These
bacteria are closely related to the ones that cause tuberculosis (TB). You can get TB when someone who is infected coughs on you, but you cannot get MAC that way. The bacteria that cause MAC are found in
soil and water and most people have already been exposed to them. Usually they do not cause illness, but when you have HIV, MAC can cause illness. The risk of developing MAC increases if your CD4 cell count
is below 100.
What do I look for?
MAC is usually scattered (disseminated) throughout many parts of the body but most commonly it infects the blood, lymph glands, bowel and lungs. The symptoms of
MAC can include: weight loss, fever, chills, anemia (low red blood cells), abdominal pain, diarrhea, severe night sweats, and loss of appetite.
How is MAC diagnosed?
Although it can be found in
other body fluids, MAC is most often diagnosed by a blood test. These blood tests can take several weeks to come back.
Can MAC be prevented?
The use of rifabutin (Mycobutin) has been studied and
is recommended as a way to prevent people with low T4 counts from developing MAC. Prevention therapy is recommended for life. There is some concern, however, of resistance developing to Rifabutin over time.
Rifabutin can interact with fluconazole (Diflucan). Therefore , care should be taken when these two drugs are taken together. Azithromycin and Clarithromycin are also options for prevention.
How is MAC treated?
There is no complete treatment for MAC. The drugs used may not get rid of the infection but they can help reduce symptoms. The recommended treatment is a combination of drugs
similar to the ones used to treat tuberculosis (TB). Some of the drugs that may be used together include: Amikacin, Ciprofloxacin, Rifabutin, Clarithromycin, Azithromycin, Rifampin, Ethambutal and
Clofazimine It can take from two to eight weeks to have any response to the treatment. Once MAC is diagnosed, treatment is recommended for life.
References
Whitehead, Mark and Patterson, Brent (1993)
. Managing your health: A guide for People with HIV or AIDS. Toronto: CATIE & Toronto PWA.
