Cytomegalovirus retinitis and viral resistance: ganciclovir resistance. CMV Retinitis and Viral Resistance Study Group.
Cytomegalovirus (CMV) retinitis is among the most common opportunistic infections in patients with AIDS and a substantial cause of visual loss. With long-term therapy, resistant CMV may develop. In a prospective study of 108 patients with CMV retinitis, 80.6% of patients were found to have either a positive blood culture or positive urine culture for CMV at the diagnosis of retinitis. At diagnosis of retinitis, 0.9% and 2.7% of patients had a ganciclovir-resistant blood culture isolate and urine culture isolate, respectively. Of 76 patients initially treated with ganciclovir, 11.4% had a resistant blood or urine culture isolate by 6 months of treatment and 27.5% by 9 months. The development of ganciclovir resistance during follow-up correlated with the occurrence of CMV retinitis in the contralateral eye (odds ratio = 9.06, P = .003).
Jabs
D A
DA
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. dajabs@welchlink.welch.jhu.edu
Enger
C
C
Dunn
J P
JP
Forman
M
M
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus / Q000187:drug effects*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies
D000998:Antiviral Agents; D015774:Ganciclovir