Do all patients with CMV retinitis require life long anti-CMV therapy?

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Abstract
Editor,—It is becoming clear that some patients with cytomegalovirus (CMV) retinitis who respond to highly active antiretroviral therapy in terms of their CD4 count and reduced HIV viral load, undergo no further reactivations of their retinitis despite having no specific anti-CMV therapy. However, the factors underlying this improved immunity to CMV are not entirely clear. We report the case of a patient on highly active antiretroviral therapy (HAART) who has had no reactivation of CMV retinitis after 6 months without anti-CMV treatment. The unusual feature of this case is that the CD4 count has remained persistently low. We discuss factors that may be relevant in the improved immune response to CMV infection and may be useful in isolating a group of patients on HAART who do not require lifelong maintenance with anti-CMV therapy. A 33 year old man with a CD4 count …