Clinical experience with cidofovir in the treatment of cytomegalovirus retinitis.
Cidofovir (Vistide, HPMPC) is a nucleotide analogue with potent in vitro activity against cytomegalovirus (CMV) that was recently licensed for treatment of patients with acquired immunodeficiency syndrome (AIDS) and CMV retinitis. Cidofovir's prolonged intracellular half-life permits dosing once every 2 weeks for maintenance treatment. The treatment-limiting toxicity of cidofovir is dose- and schedule-dependent nephrotoxicity affecting renal proximal convoluted tubule cells. A treatment regimen that includes concomitant administration of oral probenecid, intravenous hydration, and careful preinfusion evaluation of renal function with conservative dose modification has reduced cidofovir-associated nephrotoxicity. Preliminary results of clinical studies of cidofovir in AIDS patients with newly diagnosed and relapsing CMV retinitis are described.
Lalezari
J P
JP
Department of Medicine, University of California, San Francisco 94115, U.S.A.
Kuppermann
B D
BD
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077404:Cidofovir; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D003596:Cytosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000187:drug effects; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000998:Antiviral Agents; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D003596:Cytosine; D000077404:Cidofovir