LACK OF REACTIVATION OF CYTOMEGALOVIRUS (CMV) RETINITIS AFTER STOPPING CMV MAINTENANCE THERAPY IN AIDS PATIENTS WITH SUSTAINED ELEVATIONS IN CD4 T-CELLS IN RESPONSE TO HIGHLY-ACTIVE ANTIRETROVIRAL THERAPY

The suppression of human immunodeficiency virus (HIV) replication and elevation in CD4 cells observed with protease inhibitor combination re gimens known as HAART (highly active antiretroviral therapy) may allow AIDS patients to undergo an immune recovery that allows them to suppr ess the progression of cytomegalovirus (CMV) retinitis. Eleven AIDS pa tients receiving HAART with healed CMV retinitis in whom CMV-specific maintenance therapy was discontinued were studied. Median CD4 cell cou nts were 42 before the initiation of HAART and 183 at discontinuation of anti-CMV therapy. While a median 1.1 log(10) drop in plasma HIV-1 R NA was obtained between starting HAART and withdrawal of maintenance t herapy for CMV, only 3 of 11 patients maintained plasma HIV RNA below the limits of detection. Reactivation of CMV retinitis after withdrawa l of anti-CMV therapy did not occur in any of the patients observed fo r a median of 156 days (range, 92-558).