Retroviral rebound syndrome after cessation of suppressive antiretroviral therapy in three patients with chronic HIV infection.

<bold>Background: </bold>Although viral rebound follows cessation of suppressive antiretroviral therapy in chronic HIV infection, a viremic clinical syndrome has not been described.<bold>Objective: </bold>To describe a retroviral syndrome associated with cessation of effective antiretroviral therapy in chronic HIV infection.<bold>Design: </bold>Case reports.<bold>Setting: </bold>Outpatient HIV specialty clinics in Seattle, Washington, and Boston, Massachusetts.<bold>Patients: </bold>Three patients with chronic HIV infection who discontinued suppressive antiretroviral therapy.<bold>Measurements: </bold>Clinical course, plasma HIV RNA levels, and CD4 cell counts before, during, and after cessation of antiretroviral therapy.<bold>Results: </bold>Within 6 weeks after stopping antiretroviral therapy, each patient experienced a clinical illness that resembled a primary HIV syndrome. This coincided with a marked increase in HIV RNA level and, in two of three patients, a decrease in CD4 cell count. After antiretroviral therapy was restarted, each patient's symptoms rapidly resolved in association with resuppression of HIV RNA and increase in CD4 cell count or percentage.<bold>Conclusion: </bold>A retroviral rebound syndrome similar to that seen in primary HIV syndrome can occur in patients with chronic HIV infection after cessation of suppressive antiretroviral therapy. [ABSTRACT FROM AUTHOR]