Ganciclovir therapy for congenital cytomegalovirus infection in six infants.
BACKGROUND
Congenital cytomegalovirus (CMV) infection is common, and its morbidity rate is high. Ganciclovir (GCV) treatment has been used for congenital CMV infection, but there are few reports on viral loads associated with GCV therapy.


METHODS
A real-time PCR assay was used to monitor viral load in 6 cases of symptomatic CMV infection that received GCV therapy. Initially GCV was given at a dose of 5-12 mg/kg/d for 2-7 weeks. In 2 cases, additional doses were given as symptoms returned.


RESULTS
After GCV administration, active signs of chorioretinitis, thrombocytopenia and anemia disappeared or improved in all cases. During GCV therapy, viral loads decreased while patients improved clinically and increased again when GCV therapy was stopped. Although CMV DNA continued to be detectable for a long period, clinical findings did not always worsen. In 2 cases, an improvement of hearing loss was observed.


CONCLUSIONS
GCV therapy transiently suppresses the CMV concentrations. Subsequent increases of viral titers do not appear to be correlated with the clinical course or neurologic outcome.
Tanaka-Kitajima
Naoko
N
Department of Pediatrics, Nagoya Memorial Hospital, Japan.
Sugaya
Naomi
N
Futatani
Takeshi
T
Kanegane
Hirokazu
H
Suzuki
Chizuko
C
Oshiro
Makoto
M
Hayakawa
Masahiro
M
Futamura
Masahide
M
Morishima
Tsuneo
T
Kimura
Hiroshi
H
D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy*; D004279:DNA, Viral / Q000032:analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007564:Japan; D008297:Male; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D019562:Viral Load
D004279:DNA, Viral; D015774:Ganciclovir