Question

Hi,

I was recently told I have MAC again. I have a CD4 count of 207 and previously had MAC when I had zero CD4s for three years (five years ago). What does it mean to have MAC again with numbers this high?

Answer

Once acquired, MAC is never totally banished from the body of a person with a damaged immune system, even if it is not causing symptoms. You may be experiencing an "immune reconstitution syndrome". This happens when you have already acquired an opportunistic germ like MAC and now have a more active immune system because of the increase in CD4 cells. All of a sudden your body can now 'see' the MAC that was already there, and the inflammation that occurs when your immune system recognizes a germ causes symptoms.

In this situation, if the MAC is treated and if HIV therapy is continued and your immune system continues to get stronger, you will get better, and the MAC treatment can subsequently be stopped.