Journal Article

Phase I Study of Combination Therapy with Intravenous Cidofovir and Oral Ganciclovir for Cytomegalovirus Retinitis in Patients with AIDS

Mark A. Jacobson, Scarlette Wilson, Hopkins Stanley, Christopher Holtzer, Julie Cherrington and Sharon Safrin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 3, pages 528-533
Published in print March 1999 | ISSN: 1058-4838
Published online March 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515167
Phase I Study of Combination Therapy with Intravenous Cidofovir and Oral Ganciclovir for Cytomegalovirus Retinitis in Patients with AIDS

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Ganciclovir and cidofovir, two antiviral agents used in the treatment of cytomegalovirus (CMV) retinitis, have a synergistic effect inhibiting CMV replication in vitro. In a phase I study, seven patients with AIDS-related CMV retinitis were treated with cidofovir (5 mg/kg intravenously every 2 weeks) combined with ganciclovir (1 g orally three times a day). During a median of 5.5 months (range, 1–12 months) of combined therapy, only one patient had retinitis progression, and only two of 28 blood cultures (specimens of which were obtained on a monthly basis) yielded CMV. Doselimiting adverse ocular effects (anterior uveitis [two patients] and hypotony [two patients]) occurred in three of seven patients. The results suggest that combination therapy with intravenous cidofovir and oral ganciclovir (a regimen that does not require indwelling central venous catheter access) might enhance clinical efficacy. Less frequent administration of cidofovir in combination with oral ganciclovir should be prospectively studied to determine if the incidence of treatment-associated toxicity might be reduced.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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