Highly active antiretroviral therapy-related immune recovery in AIDS patients with cytomegalovirus retinitis.
Ophthalmology
; 107(5): 877-81; discussion 881-3, 2000 May.
Article
em En
| MEDLINE
| ID: mdl-10811078
ABSTRACT
OBJECTIVE:
To characterize cytomegalovirus (CMV) retinitis in human immunodeficiency virus (HIV)-infected patients who demonstrate immune recovery while receiving highly active antiretroviral therapy (HAART).DESIGN:
Consecutive, noncomparative case series.PARTICIPANTS:
Twenty-two HIV-positive patients, from two institutions, with a history of CMV retinitis, and with elevated CD4 cell counts after HAART. MAIN OUTCOMEMEASURES:
Duration of healed CMV retinitis without anti-CMV therapy, CD4 cell count, and HIV viral load. INTERVENTION Discontinuation of anti-CMV therapy after persistent elevation of CD4 cell count over 50 cell/mm3 (median, 161/mm3; range, 85-408/mm3).RESULTS:
The median period of healed CMV retinitis without anti-CMV therapy was 72 weeks (range, 33-116 weeks). Nineteen of 22 patients were still healed without anti-CMV therapy at study end. The three patients with CMV retinitis progression simultaneously had HAART, fail with CD4 cell counts of 37, 35, and 47/mm3.CONCLUSIONS:
HIV-positive patients with CMV retinitis, who demonstrate a sustained HAART-induced elevation of CD4 cell count on two consecutive counts 3 months apart and whose retinitis remains healed on anti-CMV therapy for greater than 4 months, are likely to remain healed if the anti-CMV therapy is withdrawn. It is important to monitor these patients with indirect ophthalmoscopy because HAART failure may occur and allow CMV retinitis reactivation.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Linfócitos T CD4-Positivos
/
Infecções Oportunistas Relacionadas com a AIDS
/
Retinite por Citomegalovirus
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Ophthalmology
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Estados Unidos