Discontinuation of maintenance therapy in patients with quiescent cytomegalovirus retinitis and elevated CD4+ counts

Ophthalmology
T VrabecS M Whitcup

Abstract

To determine whether maintenance therapy can be discontinued safety in patients with quiescent cytomegalovirus retinitis (CMVR) and increased CD4+ counts after treatment with highly active antiretroviral therapy (HAART). A prospective observational case series. Eight human immunodeficiency virus (HIV)-positive patients with quiescent CMVR who were taking HAART and had CD4+ counts above 100 cells/microliter elected to discontinue anti-CMV maintenance treatment. Biweekly-to-monthly indirect ophthalmoscopy and fundus photographs, monthly-to-quarterly CD4+ counts, and quarterly HIV viral loads were ordered. Twelve previously affected eyes were examined for evidence of recurrent retinitis, which was defined as any retinal whitening, border opacification, or expansion of areas of retinal pigment epithelial (RPE) atrophy greater than 750 microns. Four previously unaffected fellow eyes were observed for new CMVR. There was no reactivation or progression of retinitis in any patient during the mean follow-up interval of 11.4 months (range, 3-16 months). No previously unaffected eye developed CMVR. CD4+ remained elevated in all patients (range, 70-725; mean, 255). The HIV viral load ranged from undetectable to 139,000 copies. Discontinuat...Continue Reading

References

Jan 23, 1992·The New England Journal of Medicine·UNKNOWN Studies of Ocular Complications of AIDS Research Group, UNKNOWN AIDS Clinical Trials Group
Apr 11, 1991·The Journal of Infectious Diseases·W L DrewW C Buhles
Jan 1, 1989·Archives of Ophthalmology·D A JabsJ G Bartlett
Mar 1, 1989·Proceedings of the National Academy of Sciences of the United States of America·R J GurleyJ E Groopman
Nov 1, 1980·Annals of Internal Medicine·P R EgbertT C Merigan
Sep 7, 1995·The New England Journal of Medicine·V BaldassanoD A Jabs

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Citations

Jan 23, 2010·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Quan V HoangDebra A Goldstein
Jul 27, 2001·Current Infectious Disease Reports·Asok Kurup, Francesca J. Torriani
Apr 3, 2002·Current Infectious Disease Reports·Hansjakob Furrer, the Swiss HIV Cohort Study tS
May 23, 2003·Current Infectious Disease Reports·William Lawrence Drew
Mar 5, 2004·Survey of Ophthalmology·Tamara R Vrabec
Oct 24, 2001·Advanced Drug Delivery Reviews·T YasukawaY Ogura
Jan 6, 2001·Infectious Disease Clinics of North America·W Tantisiriwat, W G Powderly
Dec 12, 2001·HIV Medicine·D Salmon-Ceron
Apr 8, 1999·The New England Journal of Medicine·R J Whitley, G N Holland
May 11, 2000·The New England Journal of Medicine·J A Kovacs, H Masur
Apr 20, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J S Currier
Sep 15, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·W G Powderly
Dec 12, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elizabeth L Cooney
Dec 26, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Juan BerenguerUNKNOWN Madrid Group for the Study of Discontinuation of Secondary Prophylaxis in Patients with CMV Retinitis
Apr 20, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hans H HirschManuel Battegay
Apr 21, 2005·MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports·Constance A BensonUNKNOWN Infectious Diseases Society of America
Apr 20, 2002·Current Opinion in Infectious Diseases·Jane R. Deayton, Paul D. Griffiths
Aug 4, 2005·Retina·Daniel E GoldbergWilliam R Freeman
Sep 30, 1999·The British Journal of Ophthalmology·J AmbatiM R Robinson
Jun 26, 2001·The British Journal of Ophthalmology·H J ZambarakjiS M Mitchell
Dec 19, 2002·The British Journal of Ophthalmology·A AgrawalJ A Olson
Aug 17, 1999·Sexually Transmitted Infections·S Rauz, P I Murray
Jan 6, 2001·Sexually Transmitted Infections·J R Deayton
Jul 2, 2002·Infectious Diseases in Obstetrics and Gynecology·UNKNOWN US Public Health Service, Infectious Diseases Society of America, Prevention of Opportunistic Infections Working Group
Dec 7, 2007·PLoS Medicine·David HeidenW Lawrence Drew
Jan 29, 2010·Drugs & Aging·Noriyuki Kuno, Shinobu Fujii
Aug 20, 2008·Indian Journal of Ophthalmology·Jyotirmay Biswas, S Sudharshan
Apr 19, 2000·Journal of Acquired Immune Deficiency Syndromes : JAIDS·M LabetoulleH Offret
Jul 12, 2011·American Journal of Ophthalmology·Janet T HolbrookUNKNOWN Studies of Ocular Complications of AIDS (SOCA) Research Group

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