Document Detail

Update on treatment of CMV retinitis.
MedLine Citation:
PMID:  11362779     Owner:  NLM     Status:  MEDLINE    
Recent developments in the treatment of CMV retinitis are highlighted, including new methods of administering ganciclovir, and use of a new parenteral agent, cidofovir (also called HPMPC). An intraocular ganciclovir sustained-release device has been developed and tested in two different trials. This implant releases 6 mg of ganciclovir over 33 to 39 weeks. In a study randomizing eyes of thirty patients with CMV retinitis, time to disease progression was 226 days for the immediate treatment group compared to 15 days in the deferred group; adverse effects are summarized. In a second study, comparing intraocular to intravenous ganciclovir in CMV retinitis patients, implant patients had a significantly longer time to retinitis progression. Significant risks to vision were noted, however, in the implant group. In another immediate vs. deferred retinitis trial, immediate intravenous cidofovir was shown to be effective, with a six-fold increase in time to progression over those who first received therapy after evidence of first progression. The primary adverse effect of intravenous cidofovir was nephrotoxicity, which was ameliorated by hydration and probenecid. Intravitreal cidofovir was studied, also resulting in delayed progression of retinitis. Finally, the use of oral ganciclovir to prevent CMV end-organ disease resulted in a decrease of CMV infections by about fifty percent, but much controversy remains due to the involvement of multiple individual factors.
J Feinberg
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Publication Detail:
Type:  Clinical Trial; Newspaper Article; Randomized Controlled Trial    
Journal Detail:
Title:  AIDS clinical care     Volume:  7     ISSN:  1043-1543     ISO Abbreviation:  AIDS Clin Care     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1995-10-25     Completed Date:  1995-10-25     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  9000367     Medline TA:  AIDS Clin Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  71-3, 75, 78     Citation Subset:  X    
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MeSH Terms
AIDS-Related Opportunistic Infections / drug therapy*
Administration, Oral
Cytomegalovirus Retinitis / complications,  drug therapy*,  prevention & control
Cytosine / analogs & derivatives,  therapeutic use*
Drug Implants
Ganciclovir / administration & dosage,  therapeutic use*
Infusions, Intravenous
Organophosphorus Compounds / therapeutic use*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Drug Implants; 0/Organophosphonates; 0/Organophosphorus Compounds; 71-30-7/Cytosine; 82410-32-0/Ganciclovir; JIL713Q00N/cidofovir

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