PRONOUNCED ANTI-HIV-1 ACTIVITY OF FOSCARNET IN PATIENTS WITHOUT CYTOMEGALOVIRUS-INFECTION

Combined therapy using reverse transcriptase (RT) and protease inhibit ors is the current established treatment for HIV-1 infection. Foscarne t is an RT inhibitor that is a product analogue, in contrast to the wi dely used nucleoside analogues. In this study, the anti-HIV-1 effect o f foscarnet, 50 mg three times per day administered intravenously for 4 weeks, was evaluated in 10 patients with minor or no symptoms. Serio us adverse events developed in 2 patients, although most patients expe rienced some side effects. The levels of HIV-1 RNA decreased from a me dian value of 4.7 to 2.6 (10)log copies/ml. The effect was sustained t hrough 4 weeks. One week after cessation of treatment, HIV-1 RNA level s increased to baseline. In contrast, no increase in the number of CD4 (+) cells was observed, The anti-HIV-1 effect was considered to be a d irect effect on HIV-1 replication because no patient had concomitant c ytomegalovirus (CMV) infection.