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

Abstract

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