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Document 0767
DOCN M9640767
TI Controversies in the treatment of cytomegalovirus retinitis: foscarnet
versus ganciclovir.
DT 9604
AU Jabs DA; Wilmer Ophthalmological Institute, Baltimore, Maryland 21205,;
USA.
SO Infect Agents Dis. 1995 Sep;4(3):131-42. Unique Identifier : AIDSLINE
MED/96034255
AB Cytomegalovirus (CMV) retinitis is the most common intraocular infection
in patients with AIDS. Untreated, CMV retinitis is a binding disease.
Ganciclovir, a nucleoside analog, and foscarnet, a pyrophosphate analog,
are both effective in controlling CMV retinitis. A randomized,
controlled, comparative trial of foscarnet and ganciclovir demonstrated
that they were equivalent in terms of controlling CMV retinits, but that
foscarnet was associated with a longer survival, possibly due to an
antiretroviral effect of foscarnet. However, foscarnet was less well
tolerated than ganciclovir, primarily due to the nature of its side
effects. Because foscarnet and ganciclovir have different side effects,
initial treatment of CMV retinitis should be individualized. Newer
technological developments, including oral ganciclovir and the
ganciclovir intraocular device, may influence the choice of initial
treatment, particularly because of their effect on the quality of life
when compared to chronic intravenous therapy. The occurrence of relapse
and the development of resistance remain long-term concerns, which may
alter the use of anti-CMV drugs over time.
DE Antiviral Agents/ADVERSE EFFECTS/*THERAPEUTIC USE AIDS-Related
Opportunistic Infections/*DRUG THERAPY/EPIDEMIOLOGY/ ETIOLOGY Clinical
Trials Comparative Study Cytomegalovirus Retinitis/*DRUG
THERAPY/EPIDEMIOLOGY/ETIOLOGY Foscarnet/ADVERSE EFFECTS/*THERAPEUTIC
USE Fundus Oculi Ganciclovir/ADVERSE EFFECTS/*THERAPEUTIC USE Human
Randomized Controlled Trials United States/EPIDEMIOLOGY Vision
JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).