Cytomegalovirus retinitis under combination therapy with zidovudine and dideoxycytidine in advanced human immunodeficiency virus infection.
The incidence of cytomegalovirus (CMV) retinitis during combination therapy with zidovudine (azidothymidine AZT) and zalcitabine (dideoxycytidine ddC), was compared with that during monotherapy with AZT alone in patients with advanced human immunodeficiency virus (HIV) infection. A total of 85 patients with CD4 cell counts under 500/microliters were enrolled in a prospective, controlled study. Between August 1991 and June 1992, these patients were treated daily with 500 mg/kg AZT given alone (n = 42) or in combination with 0.02 mg/kg ddC (n = 43). The rate of occurrence of typical microvascular retinopathy with cotton-wool exudates was lower in patients receiving combination treatment than in those given monotherapy [10 patients (26%) receiving AZT/ddC vs 23 patients (56%) given AZT; P < or = 0.01, chi-square test]. CMV retinitis developed in 8 patients (19%) treated with AZT and in 6 patients (14%) treated with ddC and AZT (no significant difference). In contrast to recently published data, we found no decrease in the rate of occurrence of retinitis in the group under combined antiretroviral therapy but observed a significantly lower incidence of microvascular retinopathy.
Kaulen
P
P
Department of Ophthalmology, Klinikum Rudolf Virchow, Freie Universität, Berlin, Germany.
Pham
D T
DT
Baranowski
E
E
Wollensak
J
J
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D016516:CD4-CD8 Ratio; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D016047:Zalcitabine / Q000627:therapeutic use*; D015215:Zidovudine / Q000627:therapeutic use*
D015215:Zidovudine; D016047:Zalcitabine