A 15-month prospective study of 109 patients with the
acquired immune deficiency syndrome (
AIDS) or
AIDS-related complex (
ARC) was conducted. Cytomegalovirus (CMV)
retinitis developed in 18 of these patients; they were treated with
ganciclovir. Five other patients with CMV
retinitis who were not part of the prospective study were also treated with
ganciclovir. CMV
retinitis frequently involved the peripheral retina. All 23 patients treated with
ganciclovir showed clinical regression of
retinitis, although breakthrough recurrence of CMV
retinitis occurred in seven patients (30.4%) while on maintenance
therapy with
ganciclovir. During treatment,
neutropenia (less than 1000 leukocytes/mm3) developed in three patients (13%).
Ganciclovir is an effective means of
therapy for CMV
retinitis, but it must be given chronically to prevent reactivation. Breakthrough recurrences while on maintenance
therapy are not uncommon, but can be successfully treated with more aggressive treatment with
ganciclovir. In addition, the prognosis for survival of
AIDS patients being treated with
ganciclovir is improved when compared with that of untreated patients.