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

Clinical Microbiology and Infection

Volumn 12, Issue 7, 2006, Pages 666-671

  Bertschy, S ^a   Opravil, M ^b   Cavassini, M ^c   Bernasconi, E ^e   Schiffer, V ^d   Schmid, P ^f   Flepp, M ^b   Chave, J P ^c   Christen, A ^a   Furrer, Hans ^a  

^a UNIVERSITY OF BERN   (Switzerland)

^b UNIVERSITY HOSPITAL ZURICH   (Switzerland)

^c LAUSANNE UNIVERSITY HOSPITAL   (Switzerland)

^d GENEVA UNIVERSITY HOSPITALS   (Switzerland)

^e REGIONAL HOSPITAL OF LUGANO   (Switzerland)

^f CANTONAL HOSPITAL ST GALLEN   (Switzerland)

Author keywords

AIDS; CD4 cell count; Discontinuation of therapy; Encephalitis; Human immunodeficiency virus; Toxoplasmosis

Indexed keywords

ANTIPROTOZOAL AGENT; ANTIRETROVIRUS AGENT; CLINDAMYCIN; PYRIMETHAMINE; SULFADIAZINE;

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ADULT; ARTICLE; BRAIN RADIOGRAPHY; CD4 LYMPHOCYTE COUNT; CLINICAL ARTICLE; CLINICAL ASSESSMENT; CLINICAL TRIAL; COHORT ANALYSIS; DISEASE EXACERBATION; DRUG EFFICACY; DRUG RESPONSE; DRUG WITHDRAWAL; ENCEPHALITIS; FEMALE; FOLLOW UP; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS 1; MAINTENANCE THERAPY; MALE; MULTICENTER STUDY; NONHUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; PRIORITY JOURNAL; RELAPSE; TOXOPLASMOSIS; TREATMENT OUTCOME;

HUMAN IMMUNODEFICIENCY VIRUS; TOXOPLASMA;

EID: 33744932213     PISSN: 1198743X     EISSN: 14690691     Source Type: Journal    
DOI: 10.1111/j.1469-0691.2006.01459.x     Document Type: Article

References (23)

1. Luft BJ, Remington JS. Toxoplasmic encephalitis in AIDS. Clin Infect Dis 1992; 15: 211-222.
2. Oksenhendler E, Charreau I, Tournerie C, Azihary M, Carbon C, Aboulker JP. Toxoplasma gondii infection in advanced HIV infection. AIDS 1994; 8: 483-487.
3. Renold C, Sugar A, Chave JP et al. Toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. Medicine 1992; 71: 224-239.
4. USPHS/IDSA Prevention of Opportunistic Infections Working Group 1999. USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. MMWR 1999; 48 (RR-10): 1-66.
5. Cohn JA, McMeeking A, Cohen W, Jacobs J, Holzman RS. Evaluation of the policy of empiric treatment of suspected Toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. Am J Med 1989; 86: 521-527.
6. Furrer H, Egger M, Opravil M et al. Discontinuation of primary prophylaxis against Pneumocystis carinii pneumonia in HIV-1 infected adults treated with combination antiretroviral therapy. N Engl J Med 1999; 340: 1301-1306.
7. Furrer H, Opravil M, Bernasconi E et al. Stopping primary prophylaxis in HIV-1 infected patients at high risk of toxoplasma encephalitis. Lancet 2000; 335: 2217-2218.
8. Kaplan JE, Masur H, Holmes KK. Guidelines for preventing opportunistic infections among HIV-infected persons - 2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. MMWR Recomm Rep 2002; 51: 1-52.
9. Benson CA, Kaplan J, Masur H, Pau A, Holmes KK. Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. MMWR 2004; 53: 1-112.
10. Kirk O, Lundgren JD, Pedersen C, Nielsen H, Gerstoft J. Can chemoprophylaxis against opportunistic infections be discontinued after an increase in CD4 cells induced by highly active antiretroviral therapy? AIDS 1999; 13: 1647-1651.
11. Soriano V, Dona C, Rodriguez-Rosado R, Barreiro P, Gonzalez-Lahoz J. Discontinuation of secondary prophylaxis for opportunistic infections in HIV-infected patients receiving highly active antiretroviral therapy. AIDS 2000; 14: 383-386.
12. Zeller V, Truffot C, Agher R et al. Discontinuation of secondary prophylaxis against disseminated Mycobacterium avium complex infection and toxoplasmic encephalitis. Clin Infect Dis 2002; 34: 662-667.
13. Kirk O, Reiss P, Uberti-Foppa C et al. Safe interruption of maintenance therapy against previous infection with four common HIV-associated opportunistic pathogens during potent antiretroviral therapy. Ann Intern Med 2002; 137: 239-250.
14. Sudre P, Rickenbach M, Taffé P et al. Clinical epidemiology and research on HIV infection in Switzerland: The Swiss HIV Cohort Study 1988-2000. Schweiz Med Wochenschr 2000; 130: 1493-1500.
15. Schockmel GA, Yerly S, Perrin L. Detection of low HIV-1 RNA levels in plasma. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14: 179-183.
16. Fagard C, Oxenius A, Gunthard H et al. A prospective trial of structured treatment interruptions in human immunodeficiency virus infection. Arch Intern Med 2003; 163: 1220-1226.
17. Schroth G, Kretzschmar K, Gawehn J, Voigt K. Advantage of magnetic resonance imaging in the diagnosis of cerebral infections. Neuroradiology 1987; 29: 120-126.
18. Wong J, Quint DJ. Imaging of central nervous system infections. Semin Roentgenol 1999; 34: 123-143.
19. Malcolm PN, Howlett DC, Saks A et al. MRI of the brain in HIV-positive patients: What is the value of routine intravenous contrast medium? Neuroradiology 1999; 41: 687-695.
20. Jacobson MA, Schrier R, McCune JM et al. Cytomegalovirus (CMV)-specific CD4+ T lymphocyte immune function in long-term survivors of AIDS-related CMV end-organ disease who are receiving potent antiretroviral therapy. J Infect Dis 2001; 183: 1399-1404.
21. Fournier S, Rabian C, Alberti C et al. Immune recovery under highly active antiretroviral therapy is associated with restoration of lymphocyte proliferation and interferon-gamma production in the presence of Toxoplasma gondii antigens. J Infect Dis 2001; 183: 1586-1591.
22. Kang H, Suzuki Y. Requirement of non-T cells that produce gamma interferon for prevention of reactivation of Toxoplasma gondii infection in the brain. Infect Immun 2001; 69: 2920-2927.
23. Torriani FJ, Freeman WR, Macdonald JC et al. CMV retinitis recurs after stopping treatment in virological and immunological failures of potent antiretroviral therapy. AIDS 2000; 14: 173-180.