HIV Digest	HIV Digest Archive

Therapy to prevent opportunistic infection relapses in HIV patients is often unnecessary after antiretroviral treatment, according to researchers in Europe.

Researchers reviewed data from 358 patients who halted maintenance therapy against four conditions­ cytomegalovirus (CMV) disease, Mycobacterium avium complex (MAC), extrapulmonary cryptococcosis, and cerebral toxoplasmosis­ after a positive response to antiretroviral therapy. All of the patients were taking at least three antiretroviral agents, and all had achieved CD4 cell counts of at least 50 when prophylaxis was suspended, according to the report.

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During the 781 person-years of follow up, only five patients suffered relapses, study data showed. In two cases, the relapsing patients' CD4 cell count was lower than 100 when prophylaxis was discontinued. Two of the other three relapses occurred in patients who halted infection prophylaxis while their CD4 cell counts remained below 200. "Maintenance therapy against previous infection with CMV, MAC, Toxoplasma gondii, or Cryptococcus neoformans in patients with HIV infection can be interrupted after sustained CD4 count increases to greater than 200 (or possibly 100 to 200) for at least six months after the start of potent antiretroviral therapy," researchers concluded.

Editor's Note: from AIDS Weekly