When is M avium-intracellulare complex (MAC) infection prophylaxis started in pediatric HIV infection?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Prophylaxis is extremely important. Table 5 indicates the CD4+ count at which prophylaxis should be started with regard to the patient's age.

Table 5. CD4+ -Based Indications for MAC Prophylaxis (Open Table in a new window)

Age or Status

CD4+ Count, Cells/mL

< 1y

< 750

1-2 y

< 500

2-6 y

< 75

> 6 y

< 50

Previous infection

Any

Clarithromycin administered for MAC prophylaxis may also protect the patient against Cryptosporidium infection. Nitazoxanide is being investigated for treatment of cryptosporidiosis in patients with AIDS. Other drugs, such as paromomycin, azithromycin, and hyperimmune bovine colostrum have been used with suboptimal results. Octreotide must be used with caution because it can slow diarrhea but not clear the infection.

Pancreatitis and/or bowel infarction may develop.


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