Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy: Recommendations of an international panel

Richard J. Whitley, Mark A. Jacobson, Dorothy N. Friedberg, Gary N. Holland, Douglas Jabs, Douglas T. Dieterich, W. David Hardy, Michael A. Polis, Thomas A. Deutsch, Judith Feinberg, Stephen A. Spector, Sharon Walmsley, W. Lawrence Drew, William G. Powderly, Paul D. Griffiths, Constance A. Benson, Harold A. Kessler

Research output: Contribution to journalArticle

Abstract

Objective: To provide recommendations for the treatment of acquired immunodeficiency syndrome-related cytomegalovirus (CMV) end-organ diseases, including retinitis, colitis, pneumonitis, and neurologic diseases. Participants: A 17-member panel of physicians with expertise in clinical and virological research and inpatient care in the field of CMV diseases. Evidence: Available clinical and virological study results. Recommendations are rated according to the quality and strength of available evidence. Recommendations were limited to the treatment of CMV diseases; prophylaxis recommendations are not included. Process: The panel was convened in February 1997 and met regularly through November 1997. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. Conclusions: Although the epidemiological features of CMV diseases are changing in the setting of potent, combination antiretroviral therapy, continued attention must be paid to CMV diseases in patients infected with the human immunodeficiency virus to prevent irreversible end-organ dysfunction. The initial and maintenance treatment of CMV retinitis must be individualized based on the characteristics of the lesions, including location and extent, specific patient factors, and characteristics of available therapies among others. Management of relapse or refractory retinitis must be likewise individualized. Ophthalmologic screening for patients at high risk for retinitis or who have a prior diagnosis of extraretinal disease is recommended. Recommendations for gastrointestinal, pulmonary, and neurologic manifestations are included.

Original languageEnglish (US)
Pages (from-to)957-969
Number of pages13
JournalArchives of internal medicine
Volume158
Issue number9
DOIs
StatePublished - May 11 1998

Fingerprint

Cytomegalovirus
Acquired Immunodeficiency Syndrome
Guidelines
Retinitis
Therapeutics
Cytomegalovirus Retinitis
A 17
Colitis
Neurologic Manifestations
Nervous System Diseases
Inpatients
Pneumonia
HIV
Physicians
Recurrence
Lung
Research

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy : Recommendations of an international panel. / Whitley, Richard J.; Jacobson, Mark A.; Friedberg, Dorothy N.; Holland, Gary N.; Jabs, Douglas; Dieterich, Douglas T.; David Hardy, W.; Polis, Michael A.; Deutsch, Thomas A.; Feinberg, Judith; Spector, Stephen A.; Walmsley, Sharon; Lawrence Drew, W.; Powderly, William G.; Griffiths, Paul D.; Benson, Constance A.; Kessler, Harold A.

In: Archives of internal medicine, Vol. 158, No. 9, 11.05.1998, p. 957-969.

Research output: Contribution to journalArticle

Whitley, RJ, Jacobson, MA, Friedberg, DN, Holland, GN, Jabs, D, Dieterich, DT, David Hardy, W, Polis, MA, Deutsch, TA, Feinberg, J, Spector, SA, Walmsley, S, Lawrence Drew, W, Powderly, WG, Griffiths, PD, Benson, CA & Kessler, HA 1998, 'Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy: Recommendations of an international panel', Archives of internal medicine, vol. 158, no. 9, pp. 957-969. https://doi.org/10.1001/archinte.158.9.957
Whitley, Richard J. ; Jacobson, Mark A. ; Friedberg, Dorothy N. ; Holland, Gary N. ; Jabs, Douglas ; Dieterich, Douglas T. ; David Hardy, W. ; Polis, Michael A. ; Deutsch, Thomas A. ; Feinberg, Judith ; Spector, Stephen A. ; Walmsley, Sharon ; Lawrence Drew, W. ; Powderly, William G. ; Griffiths, Paul D. ; Benson, Constance A. ; Kessler, Harold A. / Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy : Recommendations of an international panel. In: Archives of internal medicine. 1998 ; Vol. 158, No. 9. pp. 957-969.
@article{8489740451ba42abbf98b56f2f8ea688,
title = "Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy: Recommendations of an international panel",
abstract = "Objective: To provide recommendations for the treatment of acquired immunodeficiency syndrome-related cytomegalovirus (CMV) end-organ diseases, including retinitis, colitis, pneumonitis, and neurologic diseases. Participants: A 17-member panel of physicians with expertise in clinical and virological research and inpatient care in the field of CMV diseases. Evidence: Available clinical and virological study results. Recommendations are rated according to the quality and strength of available evidence. Recommendations were limited to the treatment of CMV diseases; prophylaxis recommendations are not included. Process: The panel was convened in February 1997 and met regularly through November 1997. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. Conclusions: Although the epidemiological features of CMV diseases are changing in the setting of potent, combination antiretroviral therapy, continued attention must be paid to CMV diseases in patients infected with the human immunodeficiency virus to prevent irreversible end-organ dysfunction. The initial and maintenance treatment of CMV retinitis must be individualized based on the characteristics of the lesions, including location and extent, specific patient factors, and characteristics of available therapies among others. Management of relapse or refractory retinitis must be likewise individualized. Ophthalmologic screening for patients at high risk for retinitis or who have a prior diagnosis of extraretinal disease is recommended. Recommendations for gastrointestinal, pulmonary, and neurologic manifestations are included.",
author = "Whitley, {Richard J.} and Jacobson, {Mark A.} and Friedberg, {Dorothy N.} and Holland, {Gary N.} and Douglas Jabs and Dieterich, {Douglas T.} and {David Hardy}, W. and Polis, {Michael A.} and Deutsch, {Thomas A.} and Judith Feinberg and Spector, {Stephen A.} and Sharon Walmsley and {Lawrence Drew}, W. and Powderly, {William G.} and Griffiths, {Paul D.} and Benson, {Constance A.} and Kessler, {Harold A.}",
year = "1998",
month = "5",
day = "11",
doi = "10.1001/archinte.158.9.957",
language = "English (US)",
volume = "158",
pages = "957--969",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "9",

}

TY - JOUR

T1 - Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy

T2 - Recommendations of an international panel

AU - Whitley, Richard J.

AU - Jacobson, Mark A.

AU - Friedberg, Dorothy N.

AU - Holland, Gary N.

AU - Jabs, Douglas

AU - Dieterich, Douglas T.

AU - David Hardy, W.

AU - Polis, Michael A.

AU - Deutsch, Thomas A.

AU - Feinberg, Judith

AU - Spector, Stephen A.

AU - Walmsley, Sharon

AU - Lawrence Drew, W.

AU - Powderly, William G.

AU - Griffiths, Paul D.

AU - Benson, Constance A.

AU - Kessler, Harold A.

PY - 1998/5/11

Y1 - 1998/5/11

N2 - Objective: To provide recommendations for the treatment of acquired immunodeficiency syndrome-related cytomegalovirus (CMV) end-organ diseases, including retinitis, colitis, pneumonitis, and neurologic diseases. Participants: A 17-member panel of physicians with expertise in clinical and virological research and inpatient care in the field of CMV diseases. Evidence: Available clinical and virological study results. Recommendations are rated according to the quality and strength of available evidence. Recommendations were limited to the treatment of CMV diseases; prophylaxis recommendations are not included. Process: The panel was convened in February 1997 and met regularly through November 1997. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. Conclusions: Although the epidemiological features of CMV diseases are changing in the setting of potent, combination antiretroviral therapy, continued attention must be paid to CMV diseases in patients infected with the human immunodeficiency virus to prevent irreversible end-organ dysfunction. The initial and maintenance treatment of CMV retinitis must be individualized based on the characteristics of the lesions, including location and extent, specific patient factors, and characteristics of available therapies among others. Management of relapse or refractory retinitis must be likewise individualized. Ophthalmologic screening for patients at high risk for retinitis or who have a prior diagnosis of extraretinal disease is recommended. Recommendations for gastrointestinal, pulmonary, and neurologic manifestations are included.

AB - Objective: To provide recommendations for the treatment of acquired immunodeficiency syndrome-related cytomegalovirus (CMV) end-organ diseases, including retinitis, colitis, pneumonitis, and neurologic diseases. Participants: A 17-member panel of physicians with expertise in clinical and virological research and inpatient care in the field of CMV diseases. Evidence: Available clinical and virological study results. Recommendations are rated according to the quality and strength of available evidence. Recommendations were limited to the treatment of CMV diseases; prophylaxis recommendations are not included. Process: The panel was convened in February 1997 and met regularly through November 1997. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. Conclusions: Although the epidemiological features of CMV diseases are changing in the setting of potent, combination antiretroviral therapy, continued attention must be paid to CMV diseases in patients infected with the human immunodeficiency virus to prevent irreversible end-organ dysfunction. The initial and maintenance treatment of CMV retinitis must be individualized based on the characteristics of the lesions, including location and extent, specific patient factors, and characteristics of available therapies among others. Management of relapse or refractory retinitis must be likewise individualized. Ophthalmologic screening for patients at high risk for retinitis or who have a prior diagnosis of extraretinal disease is recommended. Recommendations for gastrointestinal, pulmonary, and neurologic manifestations are included.

UR - http://www.scopus.com/inward/record.url?scp=0032507777&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032507777&partnerID=8YFLogxK

U2 - 10.1001/archinte.158.9.957

DO - 10.1001/archinte.158.9.957

M3 - Article

C2 - 9588429

AN - SCOPUS:0032507777

VL - 158

SP - 957

EP - 969

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 9

ER -