Survival differences associated with treatment of cytomegalovirus retinitis in Maryland patients with AIDS, 1987-1994

Differences in survival related to treatment of cytomegalovirus (CMV) retin itis in AIDS patients were studied. The medical records of adult AIDS patients who had been diagnosed with CMV retinitis in a Maryland inpatient facility between September 1987 and Septe mber 1994 were reviewed to assess determinants of survival, including treat ment with ganciclovir and foscarnet, use of zidovudine, and demographic cha racteristics. The review was based on inpatient and outpatient medical reco rds and computerized data from the Maryland HIV Information System. Of 212 AIDS patients with CMV retinitis, 123 (58.0%) were treated exclusive ly with ganciclovir, 55 (25.9%) received foscarnet only, and the remaining 34 (16.1%) received both ganciclovir and foscarnet at some point after thei r diagnosis for CMV retinitis. Patients who received both drugs survived si gnificantly longer after the diagnosis than patients who received either dr ug by itself. The median time from diagnosis of CMV retinitis to death was 464 days for patients receiving both drugs, 225 days for ganciclovir recipi ents, and 202 days for foscarnet recipients. Other positive predictors of s urvival were male sex and use of zidovudine. Among Maryland adults with AIDS who were treated for CMV retinitis between September 1987 and September 1994, the most common treatment for the eye in fection was ganciclovir. Patients receiving both ganciclovir and foscarnet survived longer than those treated with either drug alone.