Gripshover BM, Salata RA, Valdez H, Lederman MM; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 5th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 5th 1998 Chic Ill. 1998 Feb 1-5; 5th: 171 (abstract no. 489).
Case Western Reserve University, Cleveland, OH.
To ascertain if potent antiviral therapy is associated with clinically significant immune restoration, twenty patients receiving protease-inhibitor therapy for suppression of mucosal candidiasis had their azole therapy stopped. Patients had been receiving azole therapy for a median of 18 (4-98) months and their median lowest CD4 cell count was 205 (40-670), the median CD4 cell increase was 134 (0-510) cells, the median decrease in plasma HIV-1 RNA level was 1.975 (0-3.185) logs, and the 14/20 patients (70%) had plasma HIV-1 RNA levels below the limit of detection ( less than 400 copies/ml). After a median follow-up of 5 (3-7) months, only 2/20 (10%) of patients had thrush recurrence (30 and 90 days after withdrawal); both episodes responded after a short course of fluconazole without subsequent recurrence. Both patients continued to have plasma HIV-1 RNA levels below the limit of detection at the time of recurrence, their CD4 counts were 130 and 300, and the CD4 cell increase on combination therapy was 70 and 290 cells/microliter. Neither had received new antibiotics. Maintenance therapy for mucocutaneous candidiasis with azole drugs can be safely withdrawn in patients responding to potent antiretroviral therapy. This decision can result in significant drug-related cost savings. Whether treatment with potent antiviral regimens will allow the discontinuation of other maintenance or prophylactic therapies remains to be determined.
Publication Types:
Keywords:
- Antiretroviral Therapy, Highly Active
- Antiviral Agents
- Azoles
- CD4 Lymphocyte Count
- Combined Modality Therapy
- Drug Therapy, Combination
- Humans
- Protease Inhibitors
- drug therapy
- therapy
Other ID:
UI: 102236073
From Meeting Abstracts