THE EFFECT OF VALACICLOVIR ON CYTOMEGALOVIRUS VIREMIA AND VIRURIA DETECTED BY POLYMERASE CHAIN-REACTION IN PATIENTS WITH ADVANCED HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE

Samples of blood and urine were collected at baseline, week 4, and wee k 8 and then every 8 weeks from 310 patients entering a controlled tri al of prophylaxis with valaciclovir versus acyclovir, Samples were tes ted under code by polymerase chain reaction (PCR) in one laboratory, T he median number of samples collected from each patient was 5 for bloo d (range, 0-15) and 5 for urine (range, 0-15), Both baseline PCR virem ia and PCR viruria were significantly associated with future cytomegal ovirus (CMV) disease (P = .002 and P = .02, respectively), The greates t effect of valaciclovir on CMV disease was seen in patients who were PCR-positive in blood at baseline (P = .002), although a significant e ffect was also seen in those who were PCR-negative in urine (P = .02), Thus, PCR viremia provides prognostic information about CMV disease i n AIDS patients, and valaciclovir showed activity as both a preemptive and prophylactic agent.