ACTG 341: PATHOGENESIS OF MAC DISEASE IN ADVANCED HIV 1 & HAART IMPAC

通过获取DMAC高风险受试者的骨髓活检和血液进行定量培养，确定MAC组织感染是否发生在持续菌血症之前。 通过识别与MAC疾病风险相关的免疫特征来检查免疫失调与MAC疾病之间的关系。 确定MAC感染受试者和低CD 4+计数的无症状受试者中发现的免疫细胞群和功能异常是否可以通过HAART逆转。 评价HAART后HIV RNA水平变化与相关免疫指标变化的关系。 评估基线血浆HIV-1 RNA水平、相关免疫功能异常和MAC感染状态之间的关系。 通过与血液和骨髓定量培养的相关性，评价快速且可能更敏感的新MAC检测方法的诊断效用。 检查DMAC受试者的肠道和呼吸道定植发生率，并比较定植菌株与从血液和骨髓中获得的MAC分离株的菌株鉴别和毒力特性。

To determine if tissue infection with MAC occurs prior to sustained bacteremia by obtaining bone marrow biopsies and blood for quantitative cultures from subjects at high risk for DMAC. To examine the relatioship between immune dysregulation and MAC disease by identifying immune profiles correlated with risk for MAC disease. To determine whether the abnormalities in immune cell populations and functions found in MAC- infected subjects and in asymptomatic subjects with low CD4+ counts can be reversed by HAART. To evaluate the relationship between changes in HIV RNA levels after HAART and changes in relevant immune parameters. To evaluate the relationships between baseline plasma HIV-1 RNA levels, relevant immune function abnormalities, and MAC infection status. To evaluate the diagnostic utility of rapid and potentially more sensitive new MAC detection methods by correlation with quantitative cultures of blood and bone marrow. To examine the incidence of intestinal and respiratory colonization of subjects with DMAC and compare the strain identities and virulence properties of colonizing strain(s) with MAC isolate(s) obtained from blood and bone marrow.