Rifabutin Prophylaxis against Mycobacterium avium Complex Infection

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Abstract
The article on rifabutin prophylaxis against Mycobacterium avium complex disease by Nightingale et al. (Sept. 16 issue)1 provides important information. We are perplexed by one point, however. How, in a randomized trial of 1146 patients, could the group treated with rifabutin have a 14 percent higher mean base-line CD4+ lymphocyte count, the key surrogate marker of the progression of human immunodeficiency virus (HIV) disease (mean CD4+ count, 63.5 cells per cubic millimeter, as compared with 55.5 cells per cubic millimeter for patients in the placebo group)? On the basis of data given in Table 1 of the article, the difference in the CD4+ count between groups is statistically significant (approximate T = 2.5 in both studies combined; two-tailed P = 0.01). Do the authors have any explanation for this difference?

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