Regression of cytomegalovirus retinitis without systemic anti-cytomegalovirus maintenance therapy under highly active antiretroviral therapy (HAART)

Background: The purpose of this study was to evaluate the course of CMV ret initis 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 e yes, ages 34, 43, male) with CMV retinitis. The CD4 count at the time of CM V retinitis was 20/mu l (patient I) and 35/mu l (patient 2). Under HAART th e CD4 count rose up to 202/mu l (patient 1) and 350/mu l (patient 2); the v iral 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 perio d of 21 months (patient 1)and 24 months (patient 2). Conclusions: In selected patients with immune recovery under HAART it is po ssible to discontinue systemic anti-CMV maintenance therapy.