Scientific correspondence
Suspension of anticytomegalovirus maintenance therapy following
immune recovery due to highly active antiretroviral therapy
André L L Curia b, Acácio Muralhaa, Lilia Muralhaa, Carlos Pavesiob
a Department of
Ophthalmology Fluminense Federal University, Niterói, Brazil, b Moorfields Eye Hospital, London, UK
Correspondence to: Carlos Pavesio, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK Carlos.Pavesio{at}moorfields.nthames.nhs.uk
Accepted for publication 18 October 2000
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).
METHODSRetrospective
analysis of the records of 41 patients who presented with CMV retinitis
and whose maintenance therapy was discontinued from March 1997 to
December 1999.
RESULTS41 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 ×106/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.
CONCLUSIONThe
anti-CMV maintenance therapy could be discontinued safely in patients
with CD4+ above 150 cells ×106/l although close follow up
remains necessary especially in patients whose CD4+ count drops below
this level.
© 2001 by British Journal of Ophthalmology
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