Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy

Mitchell Goldman, Robert Zackin, Carl J. Fichtenbaum, Daniel J. Skiest, Susan L. Koletar, Richard Hafner, L. Joseph Wheat, Peter M. Nyangweso, Constantin Yiannoutsos, Carol T. Schnizlein-Bick, Susan Owens, Judith A. Aberg

Research output: Contribution to journalArticle

100 Citations (Scopus)

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/mm 3. 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.

Original languageEnglish
Pages (from-to)1485-1489
Number of pages5
JournalClinical Infectious Diseases
Volume38
Issue number10
DOIs
StatePublished - May 15 2004

Fingerprint

Histoplasmosis
Safety
CD4 Lymphocyte Count
Therapeutics
Histoplasma
T-Lymphocytes
Recurrence
Observational Studies
Acquired Immunodeficiency Syndrome
HIV
Urine
Prospective Studies
Antigens
Serum

ASJC Scopus subject areas

  • Immunology

Cite this

Goldman, M., Zackin, R., Fichtenbaum, C. J., Skiest, D. J., Koletar, S. L., Hafner, R., ... Aberg, J. A. (2004). Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. Clinical Infectious Diseases, 38(10), 1485-1489. https://doi.org/10.1086/420749

Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. / Goldman, Mitchell; Zackin, Robert; Fichtenbaum, Carl J.; Skiest, Daniel J.; Koletar, Susan L.; Hafner, Richard; Wheat, L. Joseph; Nyangweso, Peter M.; Yiannoutsos, Constantin; Schnizlein-Bick, Carol T.; Owens, Susan; Aberg, Judith A.

In: Clinical Infectious Diseases, Vol. 38, No. 10, 15.05.2004, p. 1485-1489.

Research output: Contribution to journalArticle

Goldman, M, Zackin, R, Fichtenbaum, CJ, Skiest, DJ, Koletar, SL, Hafner, R, Wheat, LJ, Nyangweso, PM, Yiannoutsos, C, Schnizlein-Bick, CT, Owens, S & Aberg, JA 2004, 'Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy', Clinical Infectious Diseases, vol. 38, no. 10, pp. 1485-1489. https://doi.org/10.1086/420749
Goldman, Mitchell ; Zackin, Robert ; Fichtenbaum, Carl J. ; Skiest, Daniel J. ; Koletar, Susan L. ; Hafner, Richard ; Wheat, L. Joseph ; Nyangweso, Peter M. ; Yiannoutsos, Constantin ; Schnizlein-Bick, Carol T. ; Owens, Susan ; Aberg, Judith A. / Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. In: Clinical Infectious Diseases. 2004 ; Vol. 38, No. 10. pp. 1485-1489.
@article{3f4abc6a19134fd1a7ac481fe8bd5331,
title = "Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy",
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/mm 3. 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.",
author = "Mitchell Goldman and Robert Zackin and Fichtenbaum, {Carl J.} and Skiest, {Daniel J.} and Koletar, {Susan L.} and Richard Hafner and Wheat, {L. Joseph} and Nyangweso, {Peter M.} and Constantin Yiannoutsos and Schnizlein-Bick, {Carol T.} and Susan Owens and Aberg, {Judith A.}",
year = "2004",
month = "5",
day = "15",
doi = "10.1086/420749",
language = "English",
volume = "38",
pages = "1485--1489",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy

AU - Goldman, Mitchell

AU - Zackin, Robert

AU - Fichtenbaum, Carl J.

AU - Skiest, Daniel J.

AU - Koletar, Susan L.

AU - Hafner, Richard

AU - Wheat, L. Joseph

AU - Nyangweso, Peter M.

AU - Yiannoutsos, Constantin

AU - Schnizlein-Bick, Carol T.

AU - Owens, Susan

AU - Aberg, Judith A.

PY - 2004/5/15

Y1 - 2004/5/15

N2 - 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/mm 3. 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.

AB - 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/mm 3. 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.

UR - http://www.scopus.com/inward/record.url?scp=2442704003&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2442704003&partnerID=8YFLogxK

U2 - 10.1086/420749

DO - 10.1086/420749

M3 - Article

C2 - 15156489

AN - SCOPUS:2442704003

VL - 38

SP - 1485

EP - 1489

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 10

ER -