Cytomegalovirus (CMV) resistance in patients with CMV retinitis and AIDS treated with oral or intravenous ganciclovir

Citation
Wl. Drew et al., Cytomegalovirus (CMV) resistance in patients with CMV retinitis and AIDS treated with oral or intravenous ganciclovir, J INFEC DIS, 179(6), 1999, pp. 1352-1355
Citations number
12
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Immunology
Journal title
JOURNAL OF INFECTIOUS DISEASES
ISSN journal
00221899 → ACNP
Volume
179
Issue
6
Year of publication
1999
Pages
1352 - 1355
Database
ISI
SICI code
0022-1899(199906)179:6<1352:C(RIPW>2.0.ZU;2-5
Abstract
Treatment of cytomegalovirus (CMV) retinitis with oral ganciclovir results in relatively low plasma concentrations of drug, which theoretically could cause more frequent viral resistance compared with intravenous (iv) gancicl ovir. By use of a plaque-reduction assay to quantify phenotypic sensitivity to ganciclovir, virus isolates were studied from patients with CMV retinit is participating in four clinical trials of oral ganciclovir, Before treatm ent, 69% of patients were culture-positive but just 1.1% of patients yielde d a resistant CMV, defined as a median inhibitory concentration (IC50) >6 m u M. On treatment, the first resistant isolate was recovered at 50 days. Ov erall, 3.1% of patients receiving iv ganciclovir and 6.5% of those taking o ral ganciclovir shed resistant CMV (median ganciclovir exposures of 75 and 165 days, respectively). Since IC(50)s for clinical isolates increased prop ortionately with treatment duration, it is likely that viral resistance wou ld be more frequent with longer treatment.