AEGiS-08IAC: Safety and efficacy of combined and alternating ganciclovir and foscarnet in acute and maintenance therapy for CMV infection in HIV positive patients.

8th International AIDS Conference


Amsterdam, Netherlands — July 19-24, 1992

Print this Article


Safety and efficacy of combined and alternating ganciclovir and foscarnet in acute and maintenance therapy for CMV infection in HIV positive patients.

Int Conf AIDS 1992 Jul 19-24; 8:We54 (abstract no. WeB 1054)
Peters M, Bergmann F, Grunewald T, Pohle HD, Ruf B; II. Department of Internal Medicine, Rudolf Virchow University Hospital, Freie Universitat Berlin, Germany.

OBJECTIVE: Cytomegalovirus infections cause severe sight-threatening retinitis, colitis and encephalitis in up to 50% of patients infected with the human immunodeficiency virus (HIV) in advanced stages of immunosuppression. Ganciclovir and Foscarnet are effective antiviral agents. Chronic maintenance intravenous therapy is required to reduce the high rate of relapses in patients with AIDS. Their use is limited by their high toxicity. This study evaluated the safety and efficacy of ganciclovir/foscarnet acute phase and maintenance therapy in AIDS patients with CMV disease.

METHODS: Eight patients with AIDS and CMV infection (retinitis 4, enterocolitis 3, encephalitis 1) were treated with a three week induction therapy of ganciclovir (5 mg/kg q12h) and foscarnet (60 mg/kg q8h) followed by a maintenance therapy of both drugs every other day with a reduced dose (ganciclovir: 5 mg/kg qod; foscarnet: 120 mg/kg qod). Hematological and renal side effects were recorded as well as clinical outcome.

RESULTS: Median treatment time was 18 weeks. Median CD4 count was 22/microliters. Median hematologic parameters at entry (last recorded value) were: Hb 11 (10.5)g/L, Leucos 2.3 (2.3)/nl, Thrombos 151 (158)/nl; 2 patients required transfusions (2 each). Median renal parameters were: Crea 1.1 (1.1)mg/dL, BUN 26 (22)mg/dL. In 1 patient therapy had to be discontinued due to acute renal failure with a raise of creatinin to 4.4 mg/dL after 2 weeks of acute therapy. 5/7 patients showed an improvement of their CMV disease, in 2 a stable course was seen. During the maintenance phase no disease progression was observed. One patient died of CMV-unrelated causes.

CONCLUSIONS: Combined ganciclovir/foscarnet acute phase therapy is effective against CMV disease. Alternating ganciclovir and foscarnet maintenance therapy seems to be effective in preventing disease progression and is tolerated well. Since patients infected with HIV and CMV require life-long anti-CMV suppression therapy this regimen merits further investigation in clinical trials.

Keywords: AEGIS, Foscarnet, Ganciclovir, Cytomegalovirus Infections, Cytomegalovirus, Antiviral Agents, Retinitis, Acquired Immunodeficiency Syndrome, HIV, HIV Seropositivity, Reverse Transcriptase Inhibitors, Human, ICA8KWDaegis,foscarnet,ganciclovir,cytomegalovirusinfections,cytomegalovirus,antiviralagents,retinitis,acquiredimmunodeficiencysyndrome,hiv,hivseropositivity,reversetranscriptaseinhibitors,human,ica8
920719
WeB1054

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.