Intravitreal Cidofovir (HPMPC) Treatment of Cytomegalovirus Retinitis in Patients with Acquired Immune Deficiency Syndrome

Kirsch, Leonard S.; Arévalo, J. Fernando; Paz, Eugenio Chavez de la; Munguia, David; Clercq, E. De; Freeman, William R.

doi:10.1097/00006982-199515040-00032

Cited by 13 publications

(16 citation statements)

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“…Cidofovir has also proved efficacious, on intravitreal injection, against CMV retinitis (in patients with AIDS) (112,113), although intravitreal injection of HPMPC should be used with caution because of the risk of anterior uveitis and decrease of intraocular pressure (15).…”

Section: Clinical Usefulness Cidofovirmentioning

confidence: 99%

Clinical Potential of the Acyclic Nucleoside Phosphonates Cidofovir, Adefovir, and Tenofovir in Treatment of DNA Virus and Retrovirus Infections

2003

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The acyclic nucleoside phosphonates HPMPC (cidofovir), PMEA (adefovir), and PMPA (tenofovir) have proved to be effective in vitro (cell culture systems) and in vivo (animal models and clinical studies) against a wide variety of DNA virus and retrovirus infections: cidofovir against herpesvirus (herpes simplex virus types 1 and 2 varicella-zoster virus, cytomegalovirus [CMV], Epstein-Barr virus, and human herpesviruses 6, 7, and 8), polyomavirus, papillomavirus, adenovirus, and poxvirus (variola virus, cowpox virus, vaccinia virus, molluscum contagiosum virus, and orf virus) infections; adefovir against herpesvirus, hepadnavirus (human hepatitis B virus), and retrovirus (human immunodeficiency virus types 1 [HIV-1] and 2 [HIV-2], simian immunodeficiency virus, and feline immunodeficiency virus) infections; and tenofovir against both hepadnavirus and retrovirus infections. Cidofovir (Vistide) has been officially approved for the treatment of CMV retinitis in AIDS patients, tenofovir disoproxil fumarate (Viread) has been approved for the treatment of HIV infections (i.e., AIDS), and adefovir dipivoxil (Hepsera) has been approved for the treatment of chronic hepatitis B. Nephrotoxicity is the dose-limiting side effect for cidofovir (Vistide) when used intravenously (5 mg/kg); no toxic side effects have been described for adefovir dipivoxil and tenofovir disoproxil fumarate, at the approved doses (Hepsera at 10 mg orally daily and Viread at 300 mg orally daily)

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Section: Clinical Usefulness Cidofovirmentioning

confidence: 99%

Clinical Potential of the Acyclic Nucleoside Phosphonates Cidofovir, Adefovir, and Tenofovir in Treatment of DNA Virus and Retrovirus Infections

2003

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“…Treatment is individualized, depending upon the location of the active retinitis and the immune status of the patient. Currently available anti-CMV agents include ganciclovir (Faulds and Heel, 1990;Dunn and Jabs, 1996;Noble and Faulds, 1998;McGavin and Goa, 2001;Lalezari et al, 2002a) and its prodrug valganciclovir, (Lalezari et al, 2002b) foscarnet, (SOCAIDSRGCACTG, 1992;Jacobson, 1992;SOCAIDSRGCACTG, 1994;Ohta et al, 2001) cidofovir, (Lalezari et al, 1995;Kirsch et al, 1995;Akler et al, 1998;TSOCAIDSRGCAIDSCTG, 2000) fomivirsen, (Stone and Jaffe, 2000;AIDS, 2002a;2002b) implant, (Martin et al, 1997;Vrabec et al, 1998;Hatton et al, 1998) oral valganciclovir (Lalezari et al, 2002a). A brief summary of these drugs is provided in Table 2.…”

Section: Antiviral Therapymentioning

confidence: 99%

Herpetic Viral Retinitis

Noma¹

2013

American Journal of Virology

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Human Herpes Virus (HHV) is a DNA virus and is the most important viral pathogen causing intraocular inflammation. HHV is classified into types 1-8. Among these types, HHV-1, HHV-2, HHV-3 Varicella Zoster Virus (VZV) and HHV-5 Cytomegalovirus (CMV) are known to cause herpetic viral retinitis, including acute retinal necrosis and CMV retinitis. Herpes viral retinitis can be diagnosed from characteristic ocular findings and viral identification by PCR of the aqueous humor. Recently, therapy has become more effective than in the past. Herpes viral retinitis gradually progresses if appropriate treatment is not provided with regard to the patient's immune status. Further advances in diagnostic methods and treatment are required in the future.

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“…Oral valganciclovir has been approved by the Food and Drug Administration (FDA) for both acute induction therapy and for maintenance therapy, although substantial data have not been published. Repetitive intravitreous injections of ganciclovir, foscarnet, and cidofovir have been reported to be effective for secondary prophylaxis of CMV retinitis related to uncontrolled case series (109,110). Intraocular therapy alone does not provide protection to the contralateral eye or to other organ systems and typically is combined with oral ganciclovir (100).…”

Section: Preventing Recurrencementioning

confidence: 99%

“…Relapse of CMV retinitis occurs among patients whose anti-CMV maintenance therapies have been discontinued and whose CD4 + T lymphocyte counts have decreased to <50 cells/µL (109). Therefore, reinstitution of secondary prophylaxis should occur when the CD4 + T lymphocyte count has decreased to <100-150 cells/µL (AIII).…”

Section: Preventing Recurrencementioning

confidence: 99%