A 36-year-old is admitted to the hospital with a new diagnosis of HIV and Toxoplasma encephalitis. Treatment is immediately started with pyrimethamine, sulfadiazine, and leucovorin. Repeat brain imaging 2 weeks later demonstrates substantial improvement. They start on antiretroviral therapy, complete 6 weeks of acute therapy for Toxoplasma encephalitis, and then transition to chronic maintenance therapy (secondary prophylaxis). At a visit 18 months after the initial diagnosis of toxoplasmosis, the HIV RNA is undetectable (and has been undetectable for 15 months), the CD4 count has increased from a baseline of 34 cells/mm3 to 189 cells/mm3, and all neurologic symptoms have resolved.
For this individual who has successfully completed initial (acute) therapy for Toxoplasma encephalitis and has complete resolution of neurologic symptoms, when can they stop chronic maintenance therapy for Toxoplasma encephalitis (assume they will continue to take antiretroviral therapy with virologic suppression)?
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Question Last Updated
September 28th, 2023
September 28th, 2023
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