GANCICLOVIR THERAPY FOR CYTOMEGALOVIRUS (CMV) INFECTION OF THE CENTRAL-NERVOUS-SYSTEM IN AIDS PATIENTS - MONITORING BY CMV DNA DETECTION INCEREBROSPINAL-FLUID

Seven AIDS patients with central nervous system (CNS) disease and cyto megalovirus (CMV) DNA in cerebrospinal fluid (CSF) were evaluated befo re and 3 weeks after standard ganciclovir treatment by nested polymera se chain reaction (PCR) on limiting dilutions and by quantitative PCR, After therapy, PCR CSF was negative for CMV in 3 patients with low ba seline levels of CMV DNA and positive with decreased DNA titers in 4 p atients with higher baseline levels, CMV pp65 antigen in polymorphonuc lear leukocytes was found in 6 of 7 patients before therapy and in non e of 5 after therapy, At autopsy, CMV was found in the CNS of the 4 ca ses examined, including 3 whose CSF was continuously positive by PCR, Quantitative PCR of CSF is useful for monitoring ganciclovir treatment in CMV infection of the CNS, In AIDS patients, standard ganciclovir t reatment seems effective in reducing but not suppressing viral replica tion in severe cases of CMV infection of the CNS.