173 MYCOBACTERIUM AVIUM COMPLEX ASSOCIATED IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME IN HIV- INFECTED PATIENT Roxana Carmen Cernat 1,2 , Irina Magdalena Dumitru 1,2 *, Carmen Ilie ªerban 2 , Andra Elena Petcu 2 , Aurelia Hangan 1,2 , Luminiþa Micu 3 , Resul Ghiulendan 2,4 , Sorina Dalia Carp 2 , Eugen Dumitru 1,3,4 , Sorin Rugină 1,2,5,6 1 Faculty of Medicine, Ovidius University of Constanþa, Romania 2 Clinical Infectious Diseases Hospital Constanþa, Romania 3 County Emergency Clinical Hospital “St. Apostle Andrei”, Constanþa, Romania 4 Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG) Constanþa, Romania 5 The Academy of Romanian Scientists, Bucharest, Romania 6 Romanian Academy of Medical Sciences, Bucharest, Romania 7 Doctoral School, Ovidius University of Constanþa, Romania ABSTRACT The incidence of Mycobacterium avium Complex (MAC) Disease in HIV-infected individuals has signifcantly decreased in recent years due to the introduction of Highly Active Antiretroviral Therapy (HAART) and the initiation of Clarithromycin prophylaxis. We present the case of a patient with advanced AIDS, with generalized lymphadenopathy and digestive symptoms, diagnosed with disseminated MAC, a diagnosis which was based on the results obtained from axillary lymph node and intestinal biopsies. Considering the time of the MAC diagnosis in relation to the recent introduction of antiretroviral (ARV) therapy, we considered immune reconstitution infammatory syndrome (IRIS) with good evolution under azithromycin, ethambutol and moxifoxacin treatment. Keywords: Mycobacterium avium Complex, AIDS, Clarithromycin, prophylaxis, immune reconstitution infammatory syndrome REZUMAT Incidența Mycobacterium avium complex (MAC) la persoanele infectate cu HIV a scăzut semnifcativ în ultimii ani datorită introducerii terapiei antiretrovirale foarte active (HAART) și a inițierii proflaxiei cu claritromicină. Prezentăm cazul unui pacient cu SIDA avansat, cu limfadenopatie generalizată și simptome digestive, diagnosticat cu MAC diseminat, diagnostic care s-a bazat pe rezultatele obținute din biopsiile ganglionilor limfatici axilari și biopsiile intestinale. Având în vedere momentul diagnosticului MAC în raport cu introducerea recentă a terapiei antiretrovirale (ARV), am considerat un sindrom infamator de reconstrucţie imună (IRIS) cu evoluție bună sub tratament cu azitromicină, etambutol și moxifoxacină. Cuvinte-cheie: Mycobacterium avium complex, SIDA, Claritromicină, proflaxie, sindrom infamator de reconstrucţie imună *Corresponding author: Irina Magdalena Dumitru; email: dumitrui@hotmail.com; htps://orcid.org/0000-0003-0395-6713 1. INTRODUCTION Mycobacterium avium complex (MAC) refers to infections caused by one of two nontuberculous mycobacterial species, M. avium and M. intracellulare. M. avium is considered the most common etiologic agent in more than 95% of people living with HIV with advanced immunosuppression, the CD4 T lymphocyte (CD4) cell count < 50 cells/mm 3 being an important risk factor [1-2]. While pulmonary mycobacteriosis is usually the form found in immunocompetent patients, in HIV patients we can find several other clinical forms such as lymphatic, cutaneous, cerebral, gastrointestinal or disseminated mycobacteriosis [3]. ROMANIAN ARCHIVES OF MICROBIOLOGY AND IMMUNOLOGY, Volume 80, Issue 2, pp. 173-178, April-June 2021