Eligibility Criteria:
Inclusion Criteria
Concurrent Medication:
Allowed:
* Antiretroviral therapy.
* Maintenance or prophylactic therapy for other opportunistic infections (with the exception of specifically excluded drugs).
* Carbamazepine or theophylline.
* Isoniazid for TB prophylaxis.
PER AMENDMENT 10/10/96:
* Therapy for acute infectious processes, other than MAC, provided that the patient is stable on the therapy.
* Fluconazole therapy for maintenance or suppression of fungal infections, providing the patient has been on a stable dose for at least 4 weeks.
PER AMENDMENT 7/02/97:
* If a patient elects to receive indinavir, ORTHO/NOVUM 1/35 is an acceptable means of birth control.
Patients must have:
* HIV infection.
* Disseminated MAC disease.
* Life expectancy of at least 8 weeks.
* Consent of parent or guardian if under 18 years of age.
NOTE:
* This protocol is approved for prisoner participation.
Prior Medication:
Allowed:
PER AMENDMENT 10/10/96:
* Therapy for acute infectious processes, other than MAC, prior to study entry.
Exclusion Criteria
Co-existing Condition:
Patients with the following symptoms or conditions are excluded:
* Active mycobacterial infection other than MAC that requires treatment, with the exception of isoniazid used solely for TB prophylaxis.
Concurrent Medication:
Excluded:
* Other antimycobacterial drugs (with the exception of isoniazid for TB prophylaxis).
* Other investigational drugs unless approved by protocol chair.
PER AMENDMENT 7/2/97:
* For patients who elect to receive indinavir or ritonavir:
* Terfenadine, astemizole, cisapride, triazolam, or midazolam.
* For patients who elect to receive ritonavir:
* alprazolam, amiodarone, bepridil, bupropion, cisapride, clorazepate, clozapine, diazepam, dihydroergotamine, ergotamine, estazolam, encainide, flecainide, flurazepam, meperidine, pimozide, piroxicam, propafenone, propoxyphene, quinidine or zolpidem.
* For patients who elect to receive indinavir:
* oral contraceptives other than ORTHO/NOVUM as a sole form of birth control.
* For patients randomized to a rifabutin-containing arm:
* oral contraceptives or Norplant as a sole form of birth control.
Patients with the following prior condition are excluded:
* History of severe hypersensitivity to erythromycin, clarithromycin, azithromycin, ethambutol, rifampin, or rifabutin (including Type 1 hypersensitivity reaction, Stevens-Johnson syndrome, hepatitis, optic neuritis, or exfoliative dermatitis).
Prior Medication:
Excluded:
* Empiric or presumptive antimycobacterial therapy prior to study entry if \> 14 days, within 90 days prior to entry.
NOTE:
* Patients unwilling to discontinue presumptive therapy or empiric therapy may be enrolled with the permission of the protocol chairs, however, if they are without a MAC positive blood culture at baseline, they will have study medications discontinued (AS PER AMENDMENT 7/2/97).
PER AMENDMENT 10/10/96:
* Treatment with clarithromycin or ethambutol within 4 days of initiation of study medications.
* Treatment with rifabutin or rifampin within 7 days of initiation of study medications.