skip to main content

MAC Treatment Duration Criteria — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHIV MedicineMAC Treatment Duration CriteriaSCE Infectious Diseases

A 40-year-old man with HIV (CD4 50) develops disseminated Mycobacterium avium complex. He is started on Clarithromycin plus Ethambutol. At 6 weeks, his MAC blood cultures have sterilised and his CD4 has risen to 180 on ART. How long should MAC treatment continue?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — At least 12 months total treatment AND CD4 must remain >100 for ≥6 months on ART before considering stopping — both criteria must be met

Disseminated MAC treatment should continue for at least 12 months AND cannot be stopped until the patient has achieved sustained immune reconstitution (CD4 >100 cells/µL for ≥6 months on suppressive ART). Both criteria must be met before considering discontinuation. If treatment is stopped prematurely (before either criterion is met), relapse risk is high. After discontinuation, MAC prophylaxis is not needed if CD4 remains >100. MAC treatment should be restarted if CD4 drops below 100 again.

Reference: BHIVA 2022 – OI guidelines; ATS/IDSA 2020 – NTM; WHO 2021