Discontinuation of maintenance therapy against toxoplasma encephalitis in AIDS patients with sustained response to anti-retroviral therapy.

Détails

ID Serval
serval:BIB_D88DAC6C417D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Discontinuation of maintenance therapy against toxoplasma encephalitis in AIDS patients with sustained response to anti-retroviral therapy.
Périodique
Clinical Microbiology and Infection
Auteur(s)
Bertschy S., Opravil M., Cavassini M., Bernasconi E., Schiffer V., Schmid P., Flepp M., Chave J.P., Christen A., Furrer H.
ISSN
1198-743X
Statut éditorial
Publié
Date de publication
07/2006
Peer-reviewed
Oui
Volume
12
Numéro
7
Pages
666-671
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Résumé
Discontinuation of maintenance therapy against toxoplasma encephalitis (TE) for individuals infected with human immunodeficiency virus (HIV) who are receiving successful anti-retroviral therapy is considered safe. Nevertheless, there are few published studies concerning this issue. Within the setting of the Swiss HIV Cohort Study, this report describes a prospective study of discontinuation of maintenance therapy against TE in patients with a sustained increase of CD4 counts to > 200 cells/microL and 14% of total lymphocytes, and no active lesions on cerebral magnetic resonance imaging (MRI). In addition to clinical evaluation, cerebral MRI was performed at baseline, and 1 and 6 months following discontinuation. Twenty-six AIDS patients with a history of TE agreed to participate, but three patients (11%) could not be enrolled because they still showed enhancing cerebral lesions without a clinical correlate. One patient refused MRI after 6 months while clinically asymptomatic. Among the remaining 22 patients who discontinued maintenance therapy, one relapsed after 3 months. During a total follow-up of 58 patient-years, there was no TE relapse among the patients who had remained clinically and radiologically free of relapse during the study. Thus, discontinuation of maintenance therapy against TE was generally safe, but may fail in a minority of patients. Patients who remain clinically and radiologically free of relapse at 6 months after discontinuation are unlikely to experience a relapse of TE.
Mots-clé
AIDS-Related Opportunistic Infections/drug therapy, Acquired Immunodeficiency Syndrome/drug therapy, Adult, Animals, Anti-Retroviral Agents/therapeutic use, Antiprotozoal Agents/administration &amp, dosage, CD4 Lymphocyte Count, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Recurrence, Switzerland, Toxoplasmosis, Cerebral/drug therapy, Treatment Outcome, Viral Load
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/01/2008 20:44
Dernière modification de la notice
20/08/2019 15:58
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