Work on the diagnosis, prevention and treatment of AIDS-associated opportunistic infections continues. An in vivo study of pharmacokinetic interactions between stavudine, an anti-retroviral agent, and rifabutin, clarithromycin, fluconazole, and ganciclovir, agents used for the treatment and prevention of AIDS-associated infections, demonstrated that these drugs do not alter stavudine levels; data on the effect of stavudine on the other drugs are pending. In cytomegalovirus (CMV) retinitis, the effects of the new highly active anti-HIV regimens on the course of CMV retinitis are being evaluated in a collaborative study with the NEI in which patients with retinitis whose CD4+ T-cell counts increase in response to the new therapies discontinue anti-CMV therapy. In mycobacterial diseases, a study of the safety, tolerance, immunologic effects, and efficacy of interleukin (IL)-2 continues in patients with mycobacterial infections unresponsive to standard therapy. Molecular-based assays for CMV and Mycobacterium avium complex are being developed. Access to clinical trials by local minority populations has been improved through an outreach that includes a close relationship with a local clinic for the medically under-served. The assessment and long-term follow-up of persons with idiopathic CD4+ T-lymphocytopenia (ICL) continues to define their prognosis and the relationship between CD4+ T-cell counts and infections in this population.
