CESSATION OF CMV MAINTENANCE THERAPY IN AIDS PATIENTS WITH HEALED CMV RETINITIS UNDER HAART

97th DOG Annual Meeting 1999

K604
CESSATION OF CMV MAINTENANCE THERAPY IN AIDS PATIENTS WITH HEALED CMV RETINITIS UNDER HAART

J. Best¹, C. Althaus¹, A. Kersten¹, A. Theisen² and B. Gantke²

Purpose: Immune recovery of AIDS patients with a treated and healed CMV retinitis under HAART (highly active antiretroviral therapy) is reflected by a rise of the CD₄ cell count and a decrease of the virusload. Due to partial reconstitution of the immune status, the risk of opportunistic infections decreases, as well as the risk of reactivation of inactive CMV retinitis. Anti-CMV maintenance therapy may be stopped after HAART induced immune recovery.

Patients and Methods: We present 6 patients ( 9 eyes) with a follow-up of 4,5 month (range 2-7 month) after cessation of the CMV-specific maintenance therapy (p.o. n=7; i.v. n=2).

Results: There was no reactivation of retinal CMV infection during follow-up. The virusload (<500 Eq/ml; a single value of one patient was 2047 Eq/ml) and CD₄ cell counts (range 207-427 /µl; mean: 299 /µl) remained stable during the follow-up peroid reflecting immune recovery.

Conclusions: The presented data confirms the expected low risk of retinal CMV reativation after immune recovery in AIDS patients receiving HAART without secondary prophylaxis with an anti-CMV maintenance therapy. Regular ophthalmic and medical follow-up is a mandatory prerequisite in these patients. Cessation of maintenance therapy represents a major improvement in quality of live in AIDS patients.

¹ Eye Hospital, Heinrich-Heine-University, Moorenstraße 5, D-40225 Düsseldorf, Germany
² Department of Gastroenterology und Infectious Diseases, Heinrich- Heine-Universität, Moorenstraße 5, D-40225 Düsseldorf, Germany

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