Article révisé par les pairs
Résumé : The use of highly active antiretroviral therapy (HAART) has dramatically modified the natural history of cytomegalovirus retinitis (CMVR) in AIDS patients. In this context, we discontinued maintenance therapy in eight AIDS patients with previous CMVR and a good and persistent immune and virological response to HAART (CD4 ≥ 75/mm3 in all patients, viral load ≤ 30,000 copies of RNA/ml in seven patients and negative CMV viremia in six patients whose viremia was evaluated). The median recurrence-free interval before maintenance discontinuation was 613 days (326-787). No recurrence was observed after a median follow-up of 248 days (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 careful follow-up.