Important note: Information in this article was accurate in June 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, June 26, 2000
Prepared by AIDS Weekly editors from staff and other reports
NewsRx -- New findings from a study conducted in Texas indicate that patients who are positive for the human immunodeficiency virus (HIV) and who also have a history of cytomegalovirus (CMV) retinitis can discontinue anti-CMV treatment when they demonstrate evidence of being sustained responders to highly active antiretroviral therapy (HAART).
The study was reported in a recent edition of Ophthalmology by J.C. Macdonald and colleagues at the University of Texas Health Sciences Center ("Highly active antiretroviral therapy-related immune recovery in AIDS patients with cytomegalovirus retinitis," Ophthalmology 2000 May;107(5):877-81; discussion 881-3.
In this study, 22 consecutive patients with HIV and a past history of CMV retinitis were analyzed for various factors associated with antiretroviral therapy, including viral load, response to therapy, and indicators for anti-CMV therapy discontinuation.
The patients were able to discontinue their anti-CMV therapy when their CD4 cell counts achieved a level greater than 50 cell/mm3, according to investigators.
Macdonald et al. said, "The median period of healed CMV retinitis without anti-CMV therapy was 72 weeks (range, 33-116) weeks."
In addition, a majority of the patients deemed responders to HAART were still healed by the end of the study, even though they were not taking anti-CMV therapy (19 of 22). The three patients who did not respond to HAART continued to have low CD4 cell counts and a continued progression of CMV retinitis.
Study investigators concluded, "HIV positive patients with CMV retinitis, who demonstrate a sustained HAART-induced elevation of CD4 cell count on two consecutive counts three months apart and whose retinitis remains healed on anti-CMV therapy for greater than four months, are likely to remain healed if the anti-CMV therapy is withdrawn."
This is with the provision, however, that patients continue to receive eye examinations to check for CMV retinitis reactivation in the event that antiretroviral therapy stops working.
The corresponding author for this study is J.C. Macdonald, University of Texas, Health Sciences Center, Department of Ophthalmology, 7703 Floyd Curl Drive, San Antonio, Texas 78284.
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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