Skip to main content
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1990 Jun;66(3):156–158. doi: 10.1136/sti.66.3.156

Treatment of cytomegalovirus retinitis with zidovudine and ganciclovir in patients with AIDS: outcome and toxicity.

A B Millar 1, R F Miller 1, G Patou 1, A Mindel 1, R Marsh 1, S J Semple 1
PMCID: PMC1194494  PMID: 2164492

Abstract

Sixteen patients with the Acquired Immunodeficiency Syndrome (AIDS) and cytomegalovirus retinitis were treated with ganciclovir alone (9 patients) or ganciclovir and zidovudine (6 patients). The duration of effective treatment, that is the number of weeks during which there was no deterioration in visual symptoms or retinal appearance, was comparable in both groups. However, six of the seven patients receiving concurrent therapy had to cease treatment temporarily because of bone marrow toxicity compared with one of the nine patients treated with ganciclovir alone. It is concluded that continuous concurrent therapy with oral zidovudine and intravenous ganciclovir is not possible unless unlimited supportive therapy including blood transfusion, is available.

Full text

PDF
156

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Egbert P. R., Pollard R. B., Gallagher J. G., Merigan T. C. Cytomegalovirus retinitis in immunosuppressed hosts. II. Ocular manifestations. Ann Intern Med. 1980 Nov;93(5):664–670. doi: 10.7326/0003-4819-93-5-664. [DOI] [PubMed] [Google Scholar]
  2. Felsenstein D., D'Amico D. J., Hirsch M. S., Neumeyer D. A., Cederberg D. M., de Miranda P., Schooley R. T. Treatment of cytomegalovirus retinitis with 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine. Ann Intern Med. 1985 Sep;103(3):377–380. doi: 10.7326/0003-4819-103-3-377. [DOI] [PubMed] [Google Scholar]
  3. Fischl M. A., Richman D. D., Grieco M. H., Gottlieb M. S., Volberding P. A., Laskin O. L., Leedom J. M., Groopman J. E., Mildvan D., Schooley R. T. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987 Jul 23;317(4):185–191. doi: 10.1056/NEJM198707233170401. [DOI] [PubMed] [Google Scholar]
  4. Friedman A. H., Orellana J., Freeman W. R., Luntz M. H., Starr M. B., Tapper M. L., Spigland I., Roterdam H., Mesa Tejada R., Braunhut S. Cytomegalovirus retinitis: a manifestation of the acquired immune deficiency syndrome (AIDS). Br J Ophthalmol. 1983 Jun;67(6):372–380. doi: 10.1136/bjo.67.6.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Guyer D. R., Jabs D. A., Brant A. M., Beschorner W. E., Green W. R. Regression of cytomegalovirus retinitis with zidovudine. A clinicopathologic correlation. Arch Ophthalmol. 1989 Jun;107(6):868–874. doi: 10.1001/archopht.1989.01070010890037. [DOI] [PubMed] [Google Scholar]
  6. Harris M. L., Mathalone M. B. Intravitreal ganciclovir in CMV retinitis: case report. Br J Ophthalmol. 1989 May;73(5):382–384. doi: 10.1136/bjo.73.5.382. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Holland G. N., Pepose J. S., Pettit T. H., Gottlieb M. S., Yee R. D., Foos R. Y. Acquired immune deficiency syndrome. Ocular manifestations. Ophthalmology. 1983 Aug;90(8):859–873. doi: 10.1016/s0161-6420(83)80009-8. [DOI] [PubMed] [Google Scholar]
  8. Holland G. N., Sakamoto M. J., Hardy D., Sidikaro Y., Kreiger A. E., Frenkel L. M. Treatment of cytomegalovirus retinopathy in patients with acquired immunodeficiency syndrome. Use of the experimental drug 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine. Arch Ophthalmol. 1986 Dec;104(12):1794–1800. doi: 10.1001/archopht.1986.01050240068042. [DOI] [PubMed] [Google Scholar]
  9. Jabs D. A., Enger C., Bartlett J. G. Cytomegalovirus retinitis and acquired immunodeficiency syndrome. Arch Ophthalmol. 1989 Jan;107(1):75–80. doi: 10.1001/archopht.1989.01070010077031. [DOI] [PubMed] [Google Scholar]
  10. Jabs D. A., Newman C., De Bustros S., Polk B. F. Treatment of cytomegalovirus retinitis with ganciclovir. Ophthalmology. 1987 Jul;94(7):824–830. doi: 10.1016/s0161-6420(87)33535-3. [DOI] [PubMed] [Google Scholar]
  11. Jacobson M. A., Mills J. Serious cytomegalovirus disease in the acquired immunodeficiency syndrome (AIDS). Clinical findings, diagnosis, and treatment. Ann Intern Med. 1988 Apr;108(4):585–594. doi: 10.7326/0003-4819-108-4-585. [DOI] [PubMed] [Google Scholar]
  12. Khadem M., Kalish S. B., Goldsmith J., Fetkenhour C., O'Grady R. B., Phair J. P., Chrobak M. Ophthalmologic findings in acquired immune deficiency syndrome (AIDS). Arch Ophthalmol. 1984 Feb;102(2):201–206. doi: 10.1001/archopht.1984.01040030151015. [DOI] [PubMed] [Google Scholar]
  13. Laskin O. L., Stahl-Bayliss C. M., Kalman C. M., Rosecan L. R. Use of ganciclovir to treat serious cytomegalovirus infections in patients with AIDS. J Infect Dis. 1987 Feb;155(2):323–327. doi: 10.1093/infdis/155.2.323. [DOI] [PubMed] [Google Scholar]
  14. Masur H., Lane H. C., Palestine A., Smith P. D., Manischewitz J., Stevens G., Fujikawa L., Macher A. M., Nussenblatt R., Baird B. Effect of 9-(1,3-dihydroxy-2-propoxymethyl) guanine on serious cytomegalovirus disease in eight immunosuppressed homosexual men. Ann Intern Med. 1986 Jan;104(1):41–44. doi: 10.7326/0003-4819-104-1-41. [DOI] [PubMed] [Google Scholar]
  15. Morris J. A., Gardner M. J. Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1313–1316. doi: 10.1136/bmj.296.6632.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Orellana J., Teich S. A., Winterkorn J. S., Mathur-Wagh U., Handwerger S., Schlamm H., Malamud S. C., Yancovitz S. R., Cederberg D. M., Mildvan D. S. Treatment of cytomegalovirus retinitis with ganciclovir (9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine (BW B759U). Br J Ophthalmol. 1988 Jul;72(7):525–529. doi: 10.1136/bjo.72.7.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Palestine A. G., Rodrigues M. M., Macher A. M., Chan C. C., Lane H. C., Fauci A. S., Masur H., Longo D., Reichert C. M., Steis R. Ophthalmic involvement in acquired immunodeficiency syndrome. Ophthalmology. 1984 Sep;91(9):1092–1099. doi: 10.1016/s0161-6420(84)34201-4. [DOI] [PubMed] [Google Scholar]
  18. Skolnik P. R., Kosloff B. R., Hirsch M. S. Bidirectional interactions between human immunodeficiency virus type 1 and cytomegalovirus. J Infect Dis. 1988 Mar;157(3):508–514. doi: 10.1093/infdis/157.3.508. [DOI] [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES