Suspension of anticytomegalovirus maintenance therapy following immune recovery due to highly active antiretroviral therapy

Br J Ophthalmol. 2001 Apr;85(4):471-3. doi: 10.1136/bjo.85.4.471.

Abstract

Aim: To describe the authors' experience with discontinuation of anti-cytomegalovirus (CMV) maintenance therapy in patients showing immune recovery following highly active antiretroviral therapy (HAART).

Methods: Retrospective analysis of the records of 41 patients who presented with CMV retinitis and whose maintenance therapy was discontinued from March 1997 to December 1999.

Results: 41 patients had their anti-CMV therapy discontinued. The mean follow up after discontinuation of maintenance therapy in April 2000 was 20.4 months. At the time of discontinuation of maintenance therapy the lowest CD4+ count was 143 cells x 10(6)/l and only three patients had detectable HIV viral load. No reactivation or progression was seen in any of these patients after suspension of maintenance therapy.

Conclusion: The anti-CMV maintenance therapy could be discontinued safely in patients with CD4+ above 150 cells x 10(6)/l although close follow up remains necessary especially in patients whose CD4+ count drops below this level.

Publication types

  • Letter

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / immunology
  • Adult
  • Antiretroviral Therapy, Highly Active / methods*
  • Antiviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Cytomegalovirus Retinitis / drug therapy*
  • Cytomegalovirus Retinitis / immunology
  • Female
  • Ganciclovir / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Remission Induction
  • Retrospective Studies
  • Treatment Outcome
  • Viral Load

Substances

  • Antiviral Agents
  • Ganciclovir