Cytomegalovirus (CMV) culture results, drug resistance, and clinical outcome in patients with AIDS and CMV retinitis treated with foscarnet or ganciclovir

Douglas Jabs, Mark Jacobson

Research output: Contribution to journalArticle

Abstract

The objectives of the study were to examine the clinical significance of cytomegalovirus (CMV) culture results and drug susceptibilities in CMV isolates from patients with AIDS-related CMV retinitis. Blood and urine for CMV culture were obtained from 207 patients with newly diagnosed CMV retinitis who were enrolled in a randomized trial comparing foscarnet and ganciclovir. Culture positive rates at baseline were 45% and 71% for blood and urine, respectively. Rates decreased 3-to 10-fold after initiation of either treatment. Mortality was related to both positive baseline blood and urine cultures; adjusted relative risks were 1.97 and 2,03, respectively. Positive blood cultures at baseline were associated with more rapid retinitis progression. Drug-resistant CMV was found, over comparable follow-up periods on assigned treatment, in 4 of 8 ganciclovir-assigned patients with persistent viremia and 0 of 5 foscarnet-assigned patients with persistent viremia. Results of virologic assays of blood appear to be associated with clinical outcome of CMV retinitis.

Original languageEnglish (US)
Pages (from-to)50-58
Number of pages9
JournalJournal of Infectious Diseases
Volume176
Issue number1
StatePublished - Jul 10 1997
Externally publishedYes

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Cytomegalovirus Retinitis
Foscarnet
Ganciclovir
Cytomegalovirus
Drug Resistance
Acquired Immunodeficiency Syndrome
Viremia
Urine
Retinitis
Pharmaceutical Preparations
Mortality
Therapeutics

ASJC Scopus subject areas

  • Immunology
  • Public Health, Environmental and Occupational Health

Cite this

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title = "Cytomegalovirus (CMV) culture results, drug resistance, and clinical outcome in patients with AIDS and CMV retinitis treated with foscarnet or ganciclovir",
abstract = "The objectives of the study were to examine the clinical significance of cytomegalovirus (CMV) culture results and drug susceptibilities in CMV isolates from patients with AIDS-related CMV retinitis. Blood and urine for CMV culture were obtained from 207 patients with newly diagnosed CMV retinitis who were enrolled in a randomized trial comparing foscarnet and ganciclovir. Culture positive rates at baseline were 45{\%} and 71{\%} for blood and urine, respectively. Rates decreased 3-to 10-fold after initiation of either treatment. Mortality was related to both positive baseline blood and urine cultures; adjusted relative risks were 1.97 and 2,03, respectively. Positive blood cultures at baseline were associated with more rapid retinitis progression. Drug-resistant CMV was found, over comparable follow-up periods on assigned treatment, in 4 of 8 ganciclovir-assigned patients with persistent viremia and 0 of 5 foscarnet-assigned patients with persistent viremia. Results of virologic assays of blood appear to be associated with clinical outcome of CMV retinitis.",
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N2 - The objectives of the study were to examine the clinical significance of cytomegalovirus (CMV) culture results and drug susceptibilities in CMV isolates from patients with AIDS-related CMV retinitis. Blood and urine for CMV culture were obtained from 207 patients with newly diagnosed CMV retinitis who were enrolled in a randomized trial comparing foscarnet and ganciclovir. Culture positive rates at baseline were 45% and 71% for blood and urine, respectively. Rates decreased 3-to 10-fold after initiation of either treatment. Mortality was related to both positive baseline blood and urine cultures; adjusted relative risks were 1.97 and 2,03, respectively. Positive blood cultures at baseline were associated with more rapid retinitis progression. Drug-resistant CMV was found, over comparable follow-up periods on assigned treatment, in 4 of 8 ganciclovir-assigned patients with persistent viremia and 0 of 5 foscarnet-assigned patients with persistent viremia. Results of virologic assays of blood appear to be associated with clinical outcome of CMV retinitis.

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