Discontinuation of secondary prophylaxis against disseminated Mycobacterium avium complex infection and toxoplasmic encephalitis.
We retrospectively studied outcomes for patients infected with human immunodeficiency virus who received highly active antiretroviral therapy (HAART) and had stopped receiving secondary prophylaxis against toxoplasmic encephalitis (TE) or disseminated Mycobacterium avium complex (MAC) infection. Nineteen patients had a history of TE, and 26 had a history of disseminated MAC infection. The median duration of secondary prophylaxis was 27 months, and the median duration of HAART before discontinuation of secondary prophylaxis was 22 months. Median CD4(+) cell counts at the time of cessation of secondary prophylaxis against TE or disseminated MAC infection were 404 and 105 cells/mm(3), respectively. Plasma virus load was undetectable in 68% of the patients who had a history of TE and in 31% of patients who had a history of disseminated MAC infection. Patients were followed up for a median of 29 months after discontinuation of secondary prophylaxis; no relapses occurred in patients with a history of TE, and 3 relapses occurred in patients with a history of disseminated MAC infection (incidence, 4 relapses per 100 person-years).
Zeller
Valérie
V
Service des Maladies Infectieuses et Tropicales, CHU Pitié-Salpêtrière, 75651 Paris Cedex 013, France. valerie.zeller@psl.ap-hop-paris.fr
Truffot
Chantal
C
Agher
Rachid
R
Bossi
Philippe
P
Tubiana
Roland
R
Caumes
Eric
E
Jouan
Marc
M
Bricaire
François
F
Katlama
Christine
C
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000382:microbiology / Q000469:parasitology / Q000517:prevention & control*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018890:Chemoprevention; D004660:Encephalitis / Q000469:parasitology* / Q000517:prevention & control; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000187:drug effects; D015270:Mycobacterium avium-intracellulare Infection / Q000276:immunology / Q000517:prevention & control*; D012189:Retrospective Studies; D014123:Toxoplasmosis / Q000276:immunology / Q000517:prevention & control*