Article Abstract:
Oral ganciclovir may be effective in treating cytomegalovirus retinitis and can be administered more easily than intravenous ganciclovir. Cytomegalovirus retinitis is an eye infection common in AIDS patients that can cause vision loss. Fifty-seven AIDS patients with cytomegalovirus retinitis received intravenous ganciclovir at 5 milligrams/kilogram body weight/day and 60 patients received oral ganciclovir at 3000 mg/day. Every 2 weeks for 20 weeks, the patients were evaluated by ophthalmologists and photographs of their eyes were taken for subsequent evaluation by graders. Based on the ophthalmologists' exams, the average time from the beginning of treatment to the progression of retinitis was 96 days in the intravenous group and 68 days in the oral group. Based on the grader's evaluation of photographs, the corresponding times were 62 days for the intravenous group and 57 days for the oral group. Digestive tract side effects were similar in both groups, while shortage of blood cells and blood infections were more common in the intravenous group.
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Article Abstract:
Further research is required to determine the efficacy of oral ganciclovir instead of intravenous ganciclovir for the treatment of cytomegalovirus retinitis. Cytomegalovirus retinitis is an eye infection common in AIDS patients that can cause vision loss. The most effective means of treatment is with life-long intravenous ganciclovir which is inconvenient and can cause complications such as blood infections. A 1995 study found that the oral form of the drug was only slightly less effective than the intravenous form in slowing the progression of retinitis. However, this conclusion may be ambiguous. It remains unclear whether the oral drug is better at preventing loss of vision. Furthermore, factors other than rate of progression are important in considering the effectiveness of a drug. The greater safety, convenience, and lower cost of the oral drug should have an impact on therapy decisions. The oral drug as well as an implanted device that delivers ganciclovir are being studied further.
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Article Abstract:
Intraocular implants that provide a sustained release of ganciclovir appear to slow the progression of cytomegalovirus retinitis but do not prevent this infection of the retina from occurring in the other eye. Researchers randomly assigned 173 AIDS patients with cytomegalovirus retinitis to receive one of two dosages of ganciclovir implanted directly in the eye or intravenous ganciclovir. Those receiving intravenous ganciclovir had almost three times the risk of disease progression than those who had implants but they were half as likely to have the disease spread to the other eye.
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