TreatmentUpdate76. 9(2): 10; March, 1997
Sean Hosein

Lobucavir

In test tube experiments, the drug lobucavir has anti-herpes virus activity. Doctors in California tested several doses of this drug in 23 HIV-infected men who were also infected with CMV (but did not have CMV retinitis). The dose of 400 mg four times a day was taken orally and able to suppress the level of CMV to 1/10th its pre-study level. The drug appeared to be well tolerated and did not cause bone marrow damage. Lobucavir is made by Bristol-Myers Squibb.

DHPG pro-drug

Ganciclovir (Cytovene«, DHPG) must be given intravenously or taken in huge amounts orally to suppress CMV infection. The manufacturer, Roche, is testing the drug RS-79070 also called the ganciclovir pro-drug. Taken orally, the pro-drug is converted into ganciclovir once it is inside a cell. Using 16 HIV and CMV-infected subjects, researchers tested 4 doses of the pro-drug with or without food. Taken just once daily, the 2.26 gram dose is safe and in theory should be able to keep CMV in check. A trial of the pro-drug is planned later this year in Canada.

Ritonavir for KS?

There have been reports from doctors over the past year about improvements in the treatment of the cancer Kaposi?s sarcoma (KS) in some PHAs using protease inhibitors. So a team of Australian and US doctors recently tested the drug ritonavir in subjects with KS. They received increasing doses of ritonavir as high as 600 mg twice daily for up to 4 months. Doctors recruited 13 subjects who each had 5 KS skin lesions and who were not currently receiving chemotherapy or radiation. Half the subjects had a CD4+ count of 134 cells.

Results

According to the researchers, only 5 subjects completed the 4 months of ritonavir. They found that:

* lesions shrank or remained the same size in 4 subjects

* 9 subjects had lesions that continued to grow

* 5 reported that their lesions became swollen and painful.

The researchers concluded that ritonavir by itself did not cause any significant shrinkage of KS lesions.

REFERENCES:

1. Lalezari J, Drew WL, Jordan C, et al. In vivo anti-CMV activity and safety of oral lobucavir in HIV-infected patients. Abstract 301.

2. Brown F, Arum I, Francis G, et al. Ganciclovir prodrug-multiple dose, dose-ranging study with effect of food. Oral presentation LB19.

3.Carr A, Milliken S, Lewis C, et al. A pilot phase II safety and activity study of ritonavir in the treatment of HIV-associated cutaneous Kaposi?s sarcoma. Abstract 703.

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