Even in an era of HAART Drugs, HIV patients are vulnerable to opportunistic ...( ce of CMV retinitis in the HIV populati...),Health

ce of CMV retinitis in the HIV population is now 25 percent of what it was in the pre-HAART era, and we've seen no increase in this rate since HAART became available. The disturbing finding, however, is that among new retinitis cases, about 50 percent are occurring in patients who have failed to respond to HAART. Thus, we need to continue investigating the factors that lead to CMV retinitis," he said.

In addition, data showed a relationship between the effectiveness of anti-CMV therapy and HAART. The eye disease healed and did not reactivate in patients who underwent retinitis therapy and then had a good response to follow-up HAART. However, the retinitis did reactivate in patients who, despite anti-CMV therapy, had no follow-up HAART or a poor response to HAART.

The study findings are important for initial decision-making about anti-CMV treatment, Jacobson said. "Knowing that the clinical outcome of new CMV retinitis cases can be predicted based on likely future response to HAART, we can make the optimum choice among the available anti-CMV treatments for the patient from the earliest time of diagnosis."

In the second study on MAC prophylaxis, researchers looked at the development of resistance to two antibiotics, clarithromycin and azithromycin, that belong to a class of drugs called macrolides.

In addition to being used to prevent MAC infection, both drugs commonly are used to treat respiratory infections unrelated to MAC in all types of patients, not just the HIV population.

Study results showed that the bacteria normally present in the respiratory tract of HIV patients developed high-level resistance to the antibiotics within six weeks of starting prophylaxis.

According to lead investigator Judith Aberg, MD, the study results have key implications for determining optimum HIV treatment during the current HAART era. Respiratory infections are the leading cause of death among AIDS patients, and macrolides are frequently given as first
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Contact: Corinna Kaarlela
ckaarlela@pubaff.ucsf.edu
415-476-3804
University of California - San Francisco
27-Sep-1999

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