QUANTITATIVE SYSTEMIC AND LOCAL EVALUATION OF THE ANTIVIRAL EFFECT OFGANCICLOVIR AND FOSCARNET INDUCTION TREATMENT ON HUMAN CYTOMEGALOVIRUS GASTROINTESTINAL-DISEASE OF PATIENTS WITH AIDS

In a group of 29 AIDS patients with biopsy-proven human cytomegaloviru s (HCMV) gastrointestinal disease (GID), HCMV GID was shown to correla te mostly with systemic HCMV infection. The antiviral induction treatm ent (IT) with either ganciclovir (GCV) or foscarnet (PFA) caused a sig nificant reduction: in the level of HCMV antigenemia, viremia and leuk oDNAemia, and a complete virus clearance or a sharp drop of viral load in the blood of 13/13 patients and in the gastrointestinal (GI) mucos a of 12/13 (92%) patients in the GCV arm, and in the blood of 13/14 (9 3%) patients and in the GI mucosa of 10/12 (83%) patients in the PFA a rm of the study, respectively. Similarly, the clinical response was go od in 13/15 (87%) patients in the GCV arm and in 13/14 (93%) patients in the PFA arm. In addition, the finding that 2/6 patients positive fo r HCMV isolated from both GI mucosa and blood prior to IT were still p ositive in the GI tract after IT, suggested that IT could be prolonged to clear the virus from GI tract. In conclusion, both GCV and PFA sho wed a remarkable systemic and local antiviral effect in the treatment of HCMV GID in AIDS patients. (C) 1997 Elsevier Science B.V.