TITLE

Safety of Discontinuation of Maintenance Therapy for Disseminated Histoplasmosis after Immunologic Response to Antiretroviral Therapy

AUTHOR(S)
Goldman, Mitchell; Zackin, Robert; Fichtenbaum, Carl J.; Skiest, Daniel J.; Koletar, Susan L.; Hafner, Richard; Wheat, L. Joseph; Nyangweso, Peter M.; Yiannoutsos, Constantin T.; Schnizlein-Bick, Carol T.; Owens, Susan; Aberg, Judith A.
PUB. DATE
May 2004
SOURCE
Clinical Infectious Diseases;5/15/2004, Vol. 38 Issue 10, p1485
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
We performed a prospective observational study to assess the safety of stopping maintenance therapy for disseminated histoplasmosis among human immunodeficiency virus-infected patients after response to antiretroviral therapy. All subjects received at least 12 months of antifungal therapy and 6 months of antiretroviral therapy before entry. Negative results of fungal blood cultures, urine and serum Histoplasma antigen level of <4.1 units, and CD4+ T cell count of >150 cells/mm3 were required for eligibility. Thirty-two subjects were enrolled; the median CD4+ T cell count at study entry was 289 cells/mm3. No relapses of histoplasmosis occurred after a median duration of follow-up of 24 months. This corresponded to an observed relapse rate of 0 cases per 65 person-years. The median CD4+ T cell count at final study visit was 338 cells/mm3. Discontinuation of antifungal maintenance therapy appears to be safe for patients with acquired immunodeficiency syndrome with previously treated disseminated histoplasmosis and sustained immunologic improvement in response to antiretroviral therapy.
ACCESSION #
13077178

 

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