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Henry H. Balfour, Management of Cytomegalovirus Disease with Antiviral Drugs, Reviews of Infectious Diseases, Volume 12, Issue Supplement_7, September-October 1990, Pages S849–S860, https://doi.org/10.1093/clinids/12.Supplement_7.S849
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Abstract
Treatment of cytomegalovirus (CMV) disease met with limited success until the development of ganciclovir. Favorable clinical responses to ganciclovir have been reported in ∼80% of immunocompromised patients with CMV retinitis or gastrointestinal disease. CMV pneumonia is more difficult to treat, with therapy benefiting 10%–72% of patients. Ganciclovir must be given parenterally; the dose-limiting adverse event is neutropenia. Patients with AIDS frequently experience relapse and require maintenance therapy. Foscarnet is an attractive anti-CMV drug but must be given parenterally and is completely dependent on renal clearance for elimination. Prevention of CMV disease with antiviral drugs may be possible. Five weeks of intravenous acyclovir (500 mg/m2 three times a day) significantly reduced the risk of CMV infection and disease in seropositive allogeneic bone marrow transplant recipients. The prophylactic benefit of acyclovir has recently been confirmed and extended by a placebo-controlled trial in renal allograft recipients at the University of Minnesota. A 12-week course of high doses of oral acyclovir (3,200 mg/d) was safe and significantly reduced the incidence of CMV infection and disease.
- acquired immunodeficiency syndrome
- renal clearance function
- bone marrow transplantation, allogeneic
- neutropenia
- cytomegalovirus retinitis
- acyclovir
- gastrointestinal diseases
- antiviral agents
- foscarnet
- ganciclovir
- immunocompromised host
- cytomegalovirus infections
- cytomegalovirus
- kidney
- cytomegaloviral pneumonia
- allografting
- adverse event
- prevention
