title: [Stopping secondary prevention in AIDS patients with inactive CMV retinitis treated with HAART (highly active antiretroviral therapy)].
abstract: BACKGROUND
  Immune recovery of AIDS patients with cytomegalovirus (CMV) retinitis treated and healed by highly active antiretroviral therapy (HAART) is reflected by increased CD4 cell count and decreased virus load. Due to partial reconstitution of the immune status the risk of opportunistic infections decreases, as well as the risk of reactivating inactive CMV retinitis. It may therefore be possible to stop anti-CMV maintenance therapy may after HAART-induced immune recovery.
  
  
  METHODS
  We present six patients (nine eyes) with a follow-up of 9.5 months (range 7-12 months) after cessation of the CMV-specific maintenance therapy (five orally, one intravenously).
  
  
  RESULTS
  There was no reactivation of retinal CMV infection during the follow-up period. The virus load (< 50 Eq/ml; a single value of one patient was 2047 Eq/ml) and CD4 cell counts (range 207-454/microliter; mean: 313/microliter) remained stable during the follow-up period, reflecting immune recovery.
  
  
  CONCLUSIONS
  Our findings confirm the expected low risk of retinal CMV reactivation after immune recovery in AIDS patients receiving HAART without secondary prophylaxis with an anti-CMV maintenance therapy. Regular ophthalmic and medical follow-up is mandatory in these patients. Cessation of maintenance therapy represents a major improvement in quality of live in AIDS patients.
authors.affiliation: Augenklinik, Heinrich-Heine-Universität, Düsseldorf.
authors.forename: J
authors.initials: J
authors.lastname: Best
authors.forename: C
authors.initials: C
authors.lastname: Althaus
authors.forename: A
authors.initials: A
authors.lastname: Kersten
authors.forename: A
authors.initials: A
authors.lastname: Theisen
authors.forename: B
authors.initials: B
authors.lastname: Gantke
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000008:administration & dosage*; D000077404:Cidofovir; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D003596:Cytosine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005500:Follow-Up Studies; D017245:Foscarnet / Q000008:administration & dosage; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D017245:Foscarnet; D003596:Cytosine; D000077404:Cidofovir; D015774:Ganciclovir