Antibodies to Mycobacterium avium complex (MAC) antigens were measured by enzyme-linked immunosorbent assays and immunoblot analyses in sera from 20 patients with AIDS and disseminated MAC disease, 5 human immunodeficiency virus-seronegative patients with pulmonary MAC infections, and 20 healthy controls. Whereas enzyme-linked immunosorbent assay titers for healthy controls and patients with AIDS and MAC disease were comparable, human immunodeficiency virus-seronegative patients with MAC disease had higher anti-MAC antibody titers (P less than 0.01). Immunoblot analysis with the same sonic extracts indicated that each of the three groups had a limited heterogeneous response to M. avium antigens. No significant differences in immunoblot reactivities were detected. However, immunoblot studies with recombinant nontuberculous mycobacterial antigens revealed that sera from over 90% of the patients with MAC disease and only 25% of controls recognized a recombinant protein derived from a 35-kDa mycobacterial antigen. Although sonic extracts did not permit adequate discrimination of antibody reactivity in patients with MAC disease, recombinant antigens may be useful as indicators of disease.