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 /ADVANCE/ DUBLIN, Ohio /PRNewswire/ -- A U.S. Public Health Service (PHS) Task Force has issued recommendations for the prevention and treatment of Mycobacterium avium complex (MAC), a debilitating bacterial opportunistic infection in people with AIDS. The recommendations were developed in response to the increasing prevalence of MAC and recent advances in its prevention, diagnosis and therapy. The report appears in today's (Sept. 16) issue of the New England Journal of Medicine. The PHS Task Force was comprised of 24 experts from various backgrounds including government agencies (CDC, NIH, FDA), academia, practicing clinicians and the AIDS community.
 The PHS Task Force recommends that adults and adolescents with HIV infection and CD4 counts below 100 be administered 300 mg of Mycobutin(R) daily to prevent MAC. Patients should continue to receive preventive therapy for their lifetime. Prior to the initiation of preventative therapy, patients should be tested for active MAC, tuberculosis and other mycobacterial infections.
 "The frequency and severity with which disseminated MAC occurs makes the prevention of this infection an important goal in the management of patients with advanced HIV infection," states Fred Gordin, M.D., chief, infectious diseases, Veterans Affairs Medical Center.
 For the treatment of MAC, the Task Force recommends a multiple drug treatment which should be continued for the patient's lifetime.
 "By following these guidelines about the management of this infection, health care professionals should be able to reduce signs and symptoms associated with disseminated MAC," said Dr. Gordin.
 Disseminated MAC is a bacterial opportunistic infection that occurs in as many as 40 percent of patients with advanced HIV disease. Symptoms include weight loss, fever, abdominal pain, diarrhea, fatigue, night sweats, nausea and weakness. It is a major cause of illness among people with AIDS and appears to decrease survival.
 Additional Recommendations
 In addition to prevention and treatment guidelines, the report outlines recommendations for the diagnosis and monitoring of patients with disseminated MAC.
 According to the PHS Task Force, MAC infection produces non-specific symptoms, which can be attributed to several opportunistic infections, making early and accurate diagnosis difficult. Most patients with disseminated MAC disease have a CD4 count of 100 or less. In addition to physical symptoms, physicians should consider the time since AIDS diagnosis, significant anemia, prior opportunistic infection and interruption of AZT therapy as indicators for disseminated infection.
 According to the Task Force, a blood culture should be performed in patients with symptoms, signs or laboratory abnormalities compatible with mycobacterial infection. Blood cultures are not routinely recommended for asymptomatic individuals.
 The clinical manifestations of MAC -- fever, weight loss, fatigue, night sweats -- should be monitored frequently during the first weeks of therapy. Additionally, the efficacy of the therapeutic regimen should be measured by blood culture every four weeks during initial therapy. The majority of patients who ultimately respond show substantial clinical improvement in the first four to six weeks of therapy.
 Mycobutin was cleared for marketing in December 1992 for the prevention of disseminated MAC disease in patients with advanced HIV infection. To date, it remains the only approved therapy for the prevention of MAC. Mycobutin was developed in North America by Adria Laboratories, Columbus, Ohio, since May 1, 1993, part of the European pharmaceutical company Kabi Pharmacia.
 Adria Laboratories is devoted to research and development in the areas of oncology and immunology. Mycobutin is marketed through a co-promotional agreement between Adria and SmithKline Beecham.
 -0- 9/15/93/1800
 /CONTACT: Karin Leuffgen of Porter/Novelli, 212-315-8231/

CO: Adria Laboratories ST: Ohio IN: MTC SU: PDT

GK-OS -- NY058 -- 2307 09/15/93 14:25 EDT
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Publication:PR Newswire
Date:Sep 15, 1993

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