title: Mortality associated with resistant cytomegalovirus among patients with cytomegalovirus retinitis and AIDS.
abstract: OBJECTIVE
  To evaluate the effect of drug-resistant cytomegalovirus (CMV) on survival among patients with CMV retinitis.
  
  
  METHODS
  Prospective cohort study during 1993 to 2003.
  
  
  METHODS
  We included 266 patients with AIDS and newly diagnosed CMV retinitis treated with either ganciclovir or foscarnet.
  
  
  METHODS
  Data on ganciclovir and foscarnet resistance were obtained from blood and urine specimens collected at regular, predetermined intervals. The effect of resistant CMV on mortality was evaluated with a time-dependent Cox proportional hazard model.
  
  
  METHODS
  Mortality.
  
  
  RESULTS
  The median survival of the entire cohort was 12.6 months. Analysis of risk factors for mortality demonstrated that resistant CMV was associated with an increased mortality (hazard ratio, 1.65; 95% confidence interval, 1.05-2.56; P = 0.032). Among the other parameters tested, only time since AIDS diagnosis was associated significantly with mortality, with a hazard ratio of 1.10 per year since AIDS diagnosis (P = 0.001).
  
  
  CONCLUSIONS
  Resistant CMV is associated with increased mortality among patients with AIDS being treated for CMV retinitis.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine.douglas.jabs@mssm.edu
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Jabs
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Martin
authors.forename: Michael S
authors.initials: MS
authors.lastname: Forman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000627:therapeutic use*; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000502:physiology*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D024882:Drug Resistance, Viral; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir