title: Effect of ganciclovir for the treatment of severe cytomegalovirus-associated pneumonia in children without a specific immunocompromised state.
abstract: BACKGROUND
  This study aimed to evaluate the effectiveness of gancyclovir (GCV) treatment for severe cytomegalovirus (CMV)-associated pneumonia in immunocompetent children.
  
  
  METHODS
  We enrolled patients with CMV-associated severe pneumonia admitted to the Vietnam National Hospital of Pediatrics, Hanoi, Vietnam, from January 2010 to December 2011. On admission, though respiratory bacteria and viruses were not detected in tracheal aspirates, more than 5 × 10(3) copies/mL of CMV-DNA were detected in both tracheal aspirates and in blood plasma. GCV was given intravenously at a dose of 10 mg/kg/24 h for a duration of 14 days at most. The dose was then reduced to 5 mg/kg/24 h until CMV-DNA was not detected in plasma. The main study variables included clinical symptoms, complete blood count, hepatic and renal function, chest X-ray, CMV viral load, duration of GCV treatment and outcome.
  
  
  RESULTS
  Forty-three patients were enrolled in the study. The median age of patients was 57 (interquartile range [IQR] 45-85) days. Clinical and laboratory findings included anemia (67.4%), leukocytosis (90.7%), hepatosplenomegaly (60.5%), elevated liver enzymes (74.4%), decreased ratio of CD4: CD8-positive T lymphocytes (69.4%), and decreased serum IgG concentration (25.7%). The median duration of GCV treatment was 12 days (IQR 7-21). Thirty-seven patients (86.0%) showed normal chest X-rays at the end of treatment. One infant died (2.3%); the other children (97.7%) were discharged in good condition. There was no severe toxicity associated with GCV treatment.
  
  
  CONCLUSIONS
  GCV is safe and effective for the treatment of severe CMV-associated pneumonia in children.
authors.affiliation: Vietnam National Hospital of Pediatrics, Hanoi, Vietnam. maithanhnip2006@yahoo.com.
authors.forename: Thanh Thi Mai
authors.initials: TT
authors.lastname: Doan
authors.forename: Thuy Thi Bich
authors.initials: TT
authors.lastname: Phung
authors.forename: Hung Viet
authors.initials: HV
authors.lastname: Pham
authors.forename: Son Hong
authors.initials: SH
authors.lastname: Pham
authors.forename: Liem Thanh
authors.initials: LT
authors.lastname: Nguyen
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000187:drug effects* / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage*; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D011014:Pneumonia / Q000188:drug therapy* / Q000821:virology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir