Ganciclovir therapy in cytomegalovirus (CMV) infection in immunocompetent pediatric patients.
OBJECTIVE
To evaluate the outcome of immunocompetent pediatric patients who had positive cytomegalovirus (CMV) antigenemia and received ganciclovir.


METHODS
A retrospective review was done of patients who had a CMV infection based on positive antigenemia. Medical charts were reviewed for the following information: age, sex, underlying disease, symptoms and signs, laboratory results, complementary diagnostic procedures, duration and dose of ganciclovir therapy, concomitant medications, complications, and outcome.


RESULTS
Sixty-four patients with positive CMV antigenemia were identified; 15 patients were excluded from the study because of their underlying diseases. Of the remaining 49 patients, 26 (53%) were female; the median age was 11.5 months (range 0.3-132 months). Sixty-one percent (30/49) of these patients received ganciclovir (5-10 mg/kg/day) for a median of 14 days (range 7-42 days). Clinical findings included: fever, anemia, hepatomegaly, failure to thrive, elevated liver enzymes, splenomegaly, seizures, and thrombocytopenia. Sixty-three percent (19/30) of the treated patients had negative antigenemia at the end of therapy. CMV antigenemia remained positive in six (20%) patients. Nine patients received a second course of ganciclovir.


CONCLUSIONS
Ganciclovir was effective in 80% of patients, as determined by negative antigenemia at the end of therapy.
Avila-Agüero
María L
ML
Hospital Nacional de Niños, San José, Costa Rica. maluvi@racsa.co.cr
Paris
María M
MM
Alfaro
Wilberth
W
Avila-Agüero
Claudio R
CR
Faingezicht
Idis
I
D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000378:metabolism*; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D012189:Retrospective Studies
D000956:Antigens, Viral; D000998:Antiviral Agents; D015774:Ganciclovir