AEGiS-11IAC: Cytomegalovirus retinitis and viral resistance: prevalence of resistance at diagnosis.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Cytomegalovirus retinitis and viral resistance: prevalence of resistance at diagnosis.

Int Conf AIDS 1996 Jul 7-12; 11:218 (abstract no. Th.A.393)
Jabs DA, Dunn J, Enger C, Forman M, Bressler N, Charache P; CMV Retinitis and Viral Resistance Study, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Fax: 410-955-0629.

OBJECTIVE: To determine the prevalence of cytomegalovirus (CMV) isolates resistant to ganciclovir or foscarnet at the time of diagnosis of CMV retinitis, prior to the initiation of therapy.

METHODS: Patients with acquired immune deficiency syndrome (AIDS) and newly diagnosed CMV retinitis were enrolled in a prospective epidemiologic study. Culture of blood and urine for CMV, and testing of all positive isolates for sensitivity to ganciclovir and foscarnet were performed. Outcome measures included prevalence of the following: blood culture isolates resistant to ganciclovir (ID50 greater than 5.5 micromolars) or foscarnet (ID50 greater than 400 micromolars) and urine culture isolates resistant to ganciclovir or foscarnet.

RESULTS: Forty-nine patients were enrolled during a 13 month period. Forty-four patients had blood cultures which could be evaluated, and of these 66% were positive (59% of patients). Thirty-four patients had urine cultures which were evaluable, and of these 82% were positive (57% of patients). Overall, 78% of patients had either a positive urine or blood culture for CMV. No blood culture isolates were resistant to ganciclovir, and only 1 urine culture isolate (2% of patients) was resistant to ganciclovir. Three percent of blood culture isolates and 4% of urine culture isolates (2% and 2% of patients, respectively) were resistant to foscarnet. Overall, 4% of patients had either a blood or urine culture isolate resistant to foscarnet. There was little correlation between results of resistance testing from blood culture isolates and urine culture isolates in the same patients.

CONCLUSIONS: Resistance to ganciclovir or foscarnet at the time of diagnosis of CMV retinitis is uncommon.

Keywords: AEGIS, Cytomegalovirus Retinitis, Foscarnet, Ganciclovir, Prevalence, Cytomegalovirus, Antiviral Agents, Cytomegalovirus Infections, Acquired Immunodeficiency Syndrome, Prospective Studies, Epidemiologic Studies, Human, diagnosis, epidemiology, urine, ICA11

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