Early Diagnosis and Treatment of Opportunistic Mycobacterial Infections in HIV-Seropositive AIDS Patients

摘要

The purpose of this project was to construct a sensitive and specificserodiagnostic assay designed to identify individuals previously exposed to the serovars of Mycobacterium avium, a major opportunitic pathogen occurring as a disseminated disease in patients with AIDS. The assay was based upon the use of highly purified glycopeptidopid (GPL) antigens, which occur in the cell wall of M. avium in copious amounts, and which are serovar-specific immunodominant inducers of the humoral responses in the infected host. The primary results of the project were as follows: whereas control sera had very low reactivity to GPL antigens, a significant proportion of both HIV-negative and HIV-positive homosexual men possessed substantially elevated anti-GPL antibody levels, leading us to hypothesize that the conventional wisdom that M. avium is a terminally acquired infection by AIDS patients is incorrect, and that lifestyle practices not common in the control group may account for the widespread exposure of both healthy and HIV-positive homosexuals to this bacterium. Secondly, in a study involving patients with multiple reactivity to M. avium serovars, a number of serovars were recognized that do not usually give rise to disease, exemplifying the role of parasite pathogenic factors in the establishment of disseminated disease. (js)