Article Abstract:
Cytomegalovirus (CMV) infection is found in a large proportion of most populations. It usually causes no major problems, but it can cause severe disease in immunocompromised persons such as those with AIDS. Patients with AIDS often suffer from CMV retinitis, a sight-threatening inflammation of the retina, and CMV colitis, an inflammation of the colon which has been implicated in wasting (emaciation). At present, the only drug approved to treat CMV infection-related diseases in AIDS patients is ganciclovir. This is an antiviral drug that is activated once it enters the virus-infected cell. It inhibits viral DNA polymerase, which is needed for viral replication. Ganciclovir is highly effective, but recently ganciclovir-resistant strains of CMV have been identified. Ganciclovir may cause severe side effects. The most common is neutropenia, or abnormally low levels of the white blood cells known as neutrophils. Treatment must be stopped if the neutrophil count drops below a certain level. Neutropenia is also a side effect of zidovudine (AZT), the only drug approved to treat human immunodeficiency virus (HIV), which causes AIDS. Consequently, therapy with ganciclovir and AZT must be approached cautiously. Ganciclovir is very effective in treating CMV retinitis in most patients with AIDS. Initially, high doses are administered to stop viral replication quickly, and then a maintenance dose is given to prevent recurrence. Its use in treating other CMV-related diseases has not been studied extensively, but recent research indicates that it may have a wider range of applications. For example, ganciclovir might be used to prevent CMV diseases in other high-risk patients, such as those who have received organ transplants. Oral administration of ganciclovir is now being studied and compared with the currently used intravenous ganciclovir. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
People with AIDS (acquired immunodeficiency syndrome) almost always have positive blood tests for cytomegalovirus (CMV), a virus that can cause inflammation of the retina of the eye (retinitis), colon (colitis), esophagus (esophagitis), or liver (hepatitis), or a generalized condition of virus in the blood (viremia). An antiviral drug, ganciclovir, controls but does not cure these infections. To reduce the high rate of clinical and virologic relapse, the drug must be given intravenously over the long term. It may cause anemia, however. Zidovudine (also known as AZT) prolongs the survival and reduces the disease rate (morbidity) of patients with AIDS or AIDS-related complex, but it also causes anemia. It seemed possible that combination therapy with ganciclovir and zidovudine might improve the treatment of CMV disease; but there was concern that the two drugs used together would be toxic. Indeed, that turned out to be the case. In a study of 40 patients with both AIDS and serious CMV disease, 82 percent developed severe to life-threatening blood system (hematologic) toxic effects. Survival was not significantly improved, at a median time of six months. These effects were not the result of drug interaction, but rather the combined toxicity of the drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
More research is needed on effective ways to treat cytomegalovirus retinitis. Cytomegalovirus retinitis is an infection of the retina caused by cytomegalovirus. It is common in AIDS patients who are severely immunosuppressed. Ganciclovir, foscarnet and cidofovir are the drugs commonly used to treat the disease, but so far none has been able to prevent the progression of the disease. In addition, they must be administered intravenously and they have side effects. The ideal drug must be an oral preparation, inexpensive and able to suppress viral reproduction.
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