TY - JOUR
T1 - Intravitreous and plasma concentrations of ganciclovir and foscarnet after intravenous therapy in patients with aids and cytomegalovirus retinitis
AU - Arevalo, J. Fernando
AU - Gonzalez, Casimiro
AU - Capparelli, Edmund V.
AU - Kirsch, Leonard S.
AU - Garcia, Roberto F.
AU - Quiceno, Jose I.
AU - Connor, James D.
AU - Gambertoglio, John
AU - Bergeron-Lynn, Germaine
AU - Freeman, William R.
PY - 1995/10
Y1 - 1995/10
N2 - This study evaluated intravitreous and plasma ganciclovir and foscarnet concentrations after intravenous administration in AIDS patients with cytomegalovirus (CMV) retinitis and retinal detachment. Undiluted vitreous samples were prospectively obtained from 60 eyes (52 patients) at the time of pars plana vitrectomy. Thirty-three plasma samples (from 27 patients in the initial group of 52) were obtained simultaneously during surgery on 33 eyes. High-pressure liquid chromatography showed the mean vitreous ganciclovir concentrations in patients on induction and maintenance therapy were, respectively, 4.74 ± 1.49 �M (n = 24) and 3.29 ± 1.84 �M (n = 30; P =.005). Simultaneous plasma ganciclovir concentrations were less than the vitreous concentrations in 78% of the patients. The mean intravitreous foscarnet concentrations in patients receiving induction dosages were 189 ± 177 μM (n = 5) versus 163 ± 167 �M (n = 4; P =.20) for those receiving maintenance therapy. The foscarnet vitreous plasma concentration ratio averaged 1.43. Current drugs and doses for CMV retinitis result in borderline or progressively subtherapeutic concentrations.
AB - This study evaluated intravitreous and plasma ganciclovir and foscarnet concentrations after intravenous administration in AIDS patients with cytomegalovirus (CMV) retinitis and retinal detachment. Undiluted vitreous samples were prospectively obtained from 60 eyes (52 patients) at the time of pars plana vitrectomy. Thirty-three plasma samples (from 27 patients in the initial group of 52) were obtained simultaneously during surgery on 33 eyes. High-pressure liquid chromatography showed the mean vitreous ganciclovir concentrations in patients on induction and maintenance therapy were, respectively, 4.74 ± 1.49 �M (n = 24) and 3.29 ± 1.84 �M (n = 30; P =.005). Simultaneous plasma ganciclovir concentrations were less than the vitreous concentrations in 78% of the patients. The mean intravitreous foscarnet concentrations in patients receiving induction dosages were 189 ± 177 μM (n = 5) versus 163 ± 167 �M (n = 4; P =.20) for those receiving maintenance therapy. The foscarnet vitreous plasma concentration ratio averaged 1.43. Current drugs and doses for CMV retinitis result in borderline or progressively subtherapeutic concentrations.
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U2 - 10.1093/infdis/172.4.951
DO - 10.1093/infdis/172.4.951
M3 - Article
C2 - 7561215
AN - SCOPUS:0029093244
SN - 0022-1899
VL - 172
SP - 951
EP - 956
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -