Regression of cytomegalovirus retinitis in AIDS patients without systemic maintenance anti-cytomegalovirus therapy treated with highly active antiretroviral therapy

Abstract

BACKGROUND:

The purpose of this study was to evaluate the course of CMV retinitis after initiation of highly active antiretroviral therapy (HAART) and discontinuation of systemic anti-CMV maintenance therapy.

PATIENTS AND METHODS:

Case reports are presented for two AIDS patients (2 eyes, ages 34, 43, male) with CMV retinitis. The CD4 count at the time of CMV retinitis was 20/microliter (patient 1) and 35/microliter (patient 2). Under HAART the CD4 count rose up to 202/microliter (patient 1) and 350/microliter (patient 2); the viral load was under detection limit in both patients. At that time systemic maintenance therapy was discontinued in both patients.

RESULTS:

There was no progression of retinitis during the observation period of 21 months (patient 1) and 24 months (patient 2).

CONCLUSIONS:

In selected patients with immune recovery under HAART it is possible to discontinue systemic anti-CMV maintenance therapy.