Document Detail


Mortality associated with resistant cytomegalovirus among patients with cytomegalovirus retinitis and AIDS.
MedLine Citation:
PMID:  19818505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effect of drug-resistant cytomegalovirus (CMV) on survival among patients with CMV retinitis.
DESIGN: Prospective cohort study during 1993 to 2003.
PARTICIPANTS: We included 266 patients with AIDS and newly diagnosed CMV retinitis treated with either ganciclovir or foscarnet.
METHODS: Data on ganciclovir and foscarnet resistance were obtained from blood and urine specimens collected at regular, predetermined intervals. The effect of resistant CMV on mortality was evaluated with a time-dependent Cox proportional hazard model.
MAIN OUTCOME MEASURES: Mortality.
RESULTS: The median survival of the entire cohort was 12.6 months. Analysis of risk factors for mortality demonstrated that resistant CMV was associated with an increased mortality (hazard ratio, 1.65; 95% confidence interval, 1.05-2.56; P = 0.032). Among the other parameters tested, only time since AIDS diagnosis was associated significantly with mortality, with a hazard ratio of 1.10 per year since AIDS diagnosis (P = 0.001).
CONCLUSIONS: Resistant CMV is associated with increased mortality among patients with AIDS being treated for CMV retinitis.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
Authors:
Douglas A Jabs; Barbara K Martin; Michael S Forman;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-10-08
Journal Detail:
Title:  Ophthalmology     Volume:  117     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-02-18     Revised Date:  2011-07-19    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-132.e2     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, The Johns Hopkins University School of Medicine.douglas.jabs@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy,  mortality*,  virology
Adult
Antiretroviral Therapy, Highly Active
Antiviral Agents / therapeutic use*
Cytomegalovirus / isolation & purification,  physiology*
Cytomegalovirus Retinitis / drug therapy,  mortality*,  virology
Drug Resistance, Viral*
Female
Foscarnet / therapeutic use
Ganciclovir / therapeutic use
Humans
Male
Proportional Hazards Models
Prospective Studies
Survival Rate
Time Factors
Viral Load
Grant Support
ID/Acronym/Agency:
EY-10268/EY/NEI NIH HHS; EY-15643/EY/NEI NIH HHS; M01 RR000052-440863/RR/NCRR NIH HHS; M01-RR00052/RR/NCRR NIH HHS; R01 EY010268-10/EY/NEI NIH HHS; R03 EY015643-02/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Antiviral Agents; 4428-95-9/Foscarnet; 82410-32-0/Ganciclovir
Investigator
Investigator/Affiliation:
Douglas A Jabs / ; John G Bartlett / ; Diane M Brown / ; Lisa M Brune / ; J P Dunn / ; Richard D Semba / ; Jennifer E Thorne / ; Stephen G Bolton / ; John H Kempen / ; Paul A Latkany / ; Susan M LaSalvia / ; Tracey Miller / ; Earline Nanan / ; Quan Dong Nguyen / ; Laura G Neisser / ; Eva Rorer / ; George Peters / ; Qazi Faquir / ; Armando Oliver / ; David V Weinberg / ; Alice T Lyon / ; Annie Muñana / ; Lori Kaminski / ; Janet L Davis / ; Elias Mavofrides / ; Elizabeth Fuentes / ; Elizabeth Cruz / ; Tina A Rhee / ; Patricia Vera / ; Barbara K Martin / ; Michelle O Ricks / ; Lynn M Hutt / ; Cheryl Enger / ; Shirley Quaskey / ; Judy Southall / ; Joseph B Margolick / ; Fred Menendez / ; Matthew D Davis / ; Larry Hubbard / ; Jane Armstrong / ; Dolores Hurlburt / ; Sheri Glaeser / ; Jeff Joyce / ; Linda Kastorff / ; Nancy Robinson / ; Marilyn Vanderhoof-Young / ; Jackson J Brooks / ; Michael Forman / ; Linda Gluck / ; Tamica Hamlin / ; Huiling Hu / ; Alicja Rylka / ; Avareena Schools-Cropper /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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