Abstract
The diffusion of foscarnet into cerebrospinal fluid (CSF) was studied in 27 patients with AIDS. Foscarnet was administered intravenously at various dosages at 12-h intervals. Concentrations in plasma and CSF at the end of foscarnet infusion or 1, 3, 5, 6, and 12 h after infusion were determined by high-performance liquid chromatography. Thirty-seven samples were obtained. The median concentration of foscarnet in CSF was 80 mumol/liter (range, 0 to 500 mumol/liter). The CSF foscarnet concentration was greater than the 50% inhibitory concentration for human immunodeficiency virus type 1 and was equal to or greater than the 50% inhibitory concentration for cytomegalovirus in most cases. The penetration of foscarnet into CSF, as expressed by the ratio of the concentration in CSF to the simultaneous concentration in plasma, ranged from 0 to 3.4 (median, 0.27) and was highly correlated with the presence of cells within CSF and the length of foscarnet therapy. Good diffusion of foscarnet in CSF allows evaluation of this drug in central nervous system cytomegalovirus and human immunodeficiency virus infections in patients with AIDS.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andrei G., Snoeck R., Schols D., Goubau P., Desmyter J., De Clercq E. Comparative activity of selected antiviral compounds against clinical isolates of human cytomegalovirus. Eur J Clin Microbiol Infect Dis. 1991 Dec;10(12):1026–1033. doi: 10.1007/BF01984924. [DOI] [PubMed] [Google Scholar]
- Aweeka F. T., Gambertoglio J. G., van der Horst C., Raasch R., Jacobson M. A. Pharmacokinetics of concomitantly administered foscarnet and zidovudine for treatment of human immunodeficiency virus infection (AIDS Clinical Trials Group protocol 053). Antimicrob Agents Chemother. 1992 Aug;36(8):1773–1778. doi: 10.1128/aac.36.8.1773. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chrisp P., Clissold S. P. Foscarnet. A review of its antiviral activity, pharmacokinetic properties and therapeutic use in immunocompromised patients with cytomegalovirus retinitis. Drugs. 1991 Jan;41(1):104–129. doi: 10.2165/00003495-199141010-00009. [DOI] [PubMed] [Google Scholar]
- Eriksson B. F., Schinazi R. F. Combinations of 3'-azido-3'-deoxythymidine (zidovudine) and phosphonoformate (foscarnet) against human immunodeficiency virus type 1 and cytomegalovirus replication in vitro. Antimicrob Agents Chemother. 1989 May;33(5):663–669. doi: 10.1128/aac.33.5.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacobsen M. A., van der Horst C., Causey D. M., Dehlinger M., Hafner R., Mills J. In vivo additive antiretroviral effect of combined zidovudine and foscarnet therapy for human immunodeficiency virus infection (ACTG Protocol 053). J Infect Dis. 1991 Jun;163(6):1219–1222. doi: 10.1093/infdis/163.6.1219. [DOI] [PubMed] [Google Scholar]
- Lietman P. S. Clinical pharmacology: foscarnet. Am J Med. 1992 Feb 14;92(2A):8S–11S. doi: 10.1016/0002-9343(92)90330-e. [DOI] [PubMed] [Google Scholar]
- Oberg B. Antiviral effects of phosphonoformate (PFA, foscarnet sodium). Pharmacol Ther. 1989;40(2):213–285. doi: 10.1016/0163-7258(89)90097-1. [DOI] [PubMed] [Google Scholar]
- Pettersson K. J., Nordgren T., Westerlund D. Determination of phosphonoformate (foscarnet) in biological fluids by ion-pair reversed-phase liquid chromatography. J Chromatogr. 1989 Mar 24;488(2):447–455. doi: 10.1016/s0378-4347(00)82968-0. [DOI] [PubMed] [Google Scholar]
- Sandstrom E. G., Kaplan J. C., Byington R. E., Hirsch M. S. Inhibition of human T-cell lymphotropic virus type III in vitro by phosphonoformate. Lancet. 1985 Jun 29;1(8444):1480–1482. doi: 10.1016/s0140-6736(85)92255-x. [DOI] [PubMed] [Google Scholar]
- Sarin P. S., Taguchi Y., Sun D., Thornton A., Gallo R. C., Oberg B. Inhibition of HTLV-III/LAV replication by foscarnet. Biochem Pharmacol. 1985 Nov 15;34(22):4075–4079. doi: 10.1016/0006-2952(85)90392-2. [DOI] [PubMed] [Google Scholar]
- Sjövall J., Bergdahl S., Movin G., Ogenstad S., Saarimäki M. Pharmacokinetics of foscarnet and distribution to cerebrospinal fluid after intravenous infusion in patients with human immunodeficiency virus infection. Antimicrob Agents Chemother. 1989 Jul;33(7):1023–1031. doi: 10.1128/aac.33.7.1023. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Taburet A. M., Katlama C., Blanshard C., Zorza G., Gazzard D., Dohin E., Gazzard B. G., Frostegard C., Singlas E. Pharmacokinetics of foscarnet after twice-daily administrations for treatment of cytomegalovirus disease in AIDS patients. Antimicrob Agents Chemother. 1992 Sep;36(9):1821–1824. doi: 10.1128/aac.36.9.1821. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wahren B., Oberg B. Reversible inhibition of cytomegalovirus replication by phosphonoformate. Intervirology. 1980;14(1):7–15. doi: 10.1159/000149156. [DOI] [PubMed] [Google Scholar]