Discontinuation of maintenance therapy for CMV retinitis in AIDS patients on highly active antiretroviral therapy

The use of highly active antiretroviral therapy (HAART) has dramatically mo dified the natural history of cytomegalovirus retinitis (CMVR) in AIDS pati ents, In this context, we discontinued maintenance therapy in eight AIDS pa tients with previous CMVR and a good and persistent immune and virological response to HAART (CD4 greater than or equal to 75/ mm(3) in all patients, viral load less than or equal to 30000 copies of RNA/ml in seven patients a nd negative CMV viremia in six patients whose viremia was evaluated). The m edian recurrence-free interval before maintenance discontinuation was 613 d ays (326-787) No recurrence was observed after a median follow-up of 248 da ys (183-368) without maintenance therapy. In conclusion, discontinuation of maintenance therapy for CMVR in AIDS patients with good immune response to HAART can be considered and appears to be safe with a carful follow-up.