Abstract |
Ganciclovir is an experimental antiviral drug with activity against human cytomegalovirus (CMV). Forty patients with acquired immune deficiency syndrome ( AIDS) and CMV retinopathy were treated with ganciclovir on a compassionate protocol basis. Initial treatment doses ranged from 5.0 to 14.0 mg/kg/day for 9 to 26 days. Signs of drug response were a halt to enlargement of lesions, decreased opacification of retinal tissue, and resolution of hemorrhage and vasculitis. Complete response was seen in 88% of patients and incomplete response was seen in 9%. Vision improved or remained stable in 88% of patients. Initial treatment did not eradicate live virus from the eye. To prevent reactivation of disease, 26 patients received low-dose maintenance therapy ranging from 1.5 to 7.5 mg/kg/day, once or twice daily, 3 to 7 days per week. Reactivation of disease developed for unknown reasons in 50% of patients on continuous, uninterrupted maintenance therapy for longer than 3 weeks. Reversible neutropenia, requiring cessation of treatment, developed in 30% of patients on initial treatment and in 38% of patients on maintenance therapy. Rhegmatogenous retinal detachment was a late complication in seven patients. By reducing or delaying visual loss, ganciclovir appears to be useful in the management of CMV retinopathy in patients with AIDS.
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Authors | G N Holland, Y Sidikaro, A E Kreiger, D Hardy, M J Sakamoto, L M Frenkel, D J Winston, M S Gottlieb, Y J Bryson, R E Champlin |
Journal | Ophthalmology
(Ophthalmology)
Vol. 94
Issue 7
Pg. 815-23
(Jul 1987)
ISSN: 0161-6420 [Print] United States |
PMID | 2821464
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Acquired Immunodeficiency Syndrome
(complications)
- Acyclovir
(administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
- Adult
- Cytomegalovirus Infections
(complications, drug therapy, pathology, physiopathology)
- Female
- Ganciclovir
- Humans
- Male
- Middle Aged
- Neutropenia
(chemically induced)
- Retina
(pathology)
- Retinal Diseases
(complications, drug therapy, pathology, physiopathology)
- Vision, Ocular
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