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Cytomegalovirus retinitis outcome following maintenance therapy discontinuation in patients with immune recovery due to HAART

Purpose: To establish safety parameters for stopping anti-CMV maintenance therapy in patients who had immune recovery after highly active antiretroviral therapy. Methods: The anti-CMV maintenance therapy was stopped in 24 patients who presented with inactive CMV retinitis, CD4+ > 200 cells./mm³ and indetectlabe viral load. The pa-tients were examined every 15 days with indirect ophthal-moscopy after maintenance therapy discontinuation until december 1998. Results: None of the 24 patients presented retinitis reactvation or progression. All of them kept CD4+ counts above 200 cells/mm³. One patient presented a viral load of 4000, the others maintained indetectable viral load. The average follow-up was 10,5 months. Conclusion: We believe that our established parameters are safe to stop anti-CMV maintenance therapy although other studies should be performed. Routine ophthalmologic exa- mination,CD4+ count and the viral load are fundamental in the follow-up of patients with inactive CMV retinitis after stopping maintenance therapy.

CMV; Maintenance therapy; Immune recovery; HAART


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