Concurrent Medication:
Allowed:
- Preventive therapy with isoniazid for M. tuberculosis.
- Maintenance therapy for CMV retinitis.
Patients must have:
- HIV infection or history of an AIDS-defining condition by CDC criteria.
- One documented CD4 count
- NO active MAC disease, MAC bacteremia, or active mycobacterial infection (tuberculous
or nontuberculous).
- NO acute opportunistic infection.
- Life expectancy of more than 6 months.
- Consent of parent or guardian if less than legal age of consent.
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
ALL PATIENTS -
- Unexplained fevers, elevation in alkaline phosphatase, pancytopenia, abnormal liver
function tests, or odynophagia for which the diagnoses of MAC and fungal infections
have not been excluded.
- Serious hypersensitivity reactions to macrolides or rifampin.
- Unable to tolerate oral medications. FOR FLUCONAZOLE RANDOMIZATION -
- Serious hypersensitivity reaction to fluconazole.
- Active fungal infection (cryptococcosis, histoplasmosis, blastomycosis, aspergillosis,
Candida esophagitis, thrush, vaginal candidiasis).
- Positive baseline urine cryptococcal culture.
Concurrent Medication:
Excluded for fluconazole randomization:
- Maintenance therapy for deep fungal infections.
- Chronic therapy with ketoconazole or fluconazole.