MEDICAL UPDATE: Treating Peripheral CMV Retinitis

MEDICAL UPDATE: Treating Peripheral CMV Retinitis

Being Alive/Los Angeles; Being Alive Newsletter - November 1993
presented by Mark Katz, MD and reported by Jim Stoecker

Health care providers have two drugs available to treat CMV retinitis: ganciclovir and foscarnet. Each drug alone can help forestall the spread of the disease. Studies are underway to see if combining these drugs might strengthen efficacy.

Both ganciclovir and foscarnet are costly drugs that require a permanent line for infusion. When combined with AZT antiviral therapy, they can cause a serious drop in white blood cell count. For these reasons, physicians normally only use these drugs when an individual's sight is threatened by CMV retinitis. In cases where there is only peripheral infection, the standard has been to hold off on treatment.

A recent study, published in the Journal of Infectious Diseases (September 1993), followed a group that was treated with IV ganciclovir when peripheral CMV was first detected. This group was compared to a control group whose peripheral CMV went untreated. Not surprisingly, the treated group had a significantly lower rate of progression to sight-threatening retinitis than did the deferred group. This may mean that physicians will become more aggressive in treating peripheral CMV retinitis and that the standard of care will change.
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