Treatment of Cytomegalovirus Retinitis with Intravitreous Cidofovir in Patients with AIDS: A Preliminary Report

Rahhal, Firas M.; Arévalo, J. Fernando; Paz, Eugenio Chavez de la; Munguia, David; Azen, Stanley P.; Freeman, William R.

doi:10.7326/0003-4819-125-2-199607150-00003

Cited by 44 publications

(15 citation statements)

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“…[22][23][24][25] In these patients, CMV retinitis remained healed or stabilized with consecutive cidofovir injections. However, 3 (5%) of 64 patients demonstrated clinical resistance.…”

Section: Resultsmentioning

confidence: 99%

“…24,25 The median time to failure exceeds the 120 days to progression seen with IV cidofovir. 37,10 Although initially it appeared that the ophthalmologic adverse effect profile of IV cidofovir was better than that of intravitreous cidofovir, 27 a recent report suggests that this may not be true and that the incidence of cidofovir-related intraocular inflammation and hypotony may be similar with both forms of administration.…”

Section: Commentmentioning

confidence: 99%

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Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Smith

Taşkintuna²,

Rahhal³

et al. 1998

Arch Ophthalmol

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To determine the incidence of clinical resistance to intraocular cidofovir injection for treatment of acquired immunodeficiency syndrome (AIDS)related cytomegalovirus (CMV) retinitis, and to identify virologic features associated with cidofovir treatment failure.Patients and Methods: Clinical resistance to intravitreal cidofovir was examined in 64 patients with CMV retinitis who received at least 1 injection of 20 µg of cidofovir. Histopathologic examination, culture, and polymerase chain reaction were used to detect CMV in ocular specimens. Antiviral resistance was assessed by plaque reduction assay and DNA sequencing.Results: Clinical resistance to intravitreal cidofovir injections was identified in 3 patients (5%) and was asso-ciated with prior oral ganciclovir or intravenous cidofovir use. Ganciclovir-and cidofovir-resistant CMV isolates were cultured from 2 patients and harbored resistanceassociated mutations in the UL97 and polymerase genes. Resistance mutations were also detected by direct analysis of vitreous. In 1 patient, different resistance mutations were identified in ocular vs extraocular CMV strains.

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“…[22][23][24][25] In these patients, CMV retinitis remained healed or stabilized with consecutive cidofovir injections. However, 3 (5%) of 64 patients demonstrated clinical resistance.…”

Section: Resultsmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Smith

Taşkintuna²,

Rahhal³

et al. 1998

Arch Ophthalmol

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“…Finally, there have been pilot studies of intraocular therapy with foscarnet injections (23) and cidofovir injections (24). The data regarding these two intraocular therapies are extremely limited, and definitive recommendations cannot be made at this time.…”

Section: Intravitreal Foscarnet and Cidofovirmentioning

confidence: 99%

Treatment of Cytomegalovirus Retinitis: A Growing Number of Options

Shafran¹,

Conly²

1996

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…In another study, 22 AIDS patients with' CMV retinitis were treated with intravitreal dosing of 20 pg cidofovir every 5-6 weeks as maintenance therapy [84], No adjunc tive systemic anti-CMV therapy was given during the study period. None of the patients with prior untreated CMV retinitis (11 patients.…”

Section: Studies Regarding Cidofovirmentioning

confidence: 99%

Treatment of Cytomegalovirus Diseases

Vogel

Scholz²,

Cinatl³

1997

Intervirology

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This review summarizes current strategies for the treatment of human cytomegalovirus (CMV) infection/diseases in high-risk patients such as transplant recipients and AIDS patients. Since the major drugs ganciclovir (Cytovene), foscarnet (Foscavir) and cidofovir (Vistide) are frequently associated with severe side effects and the formation of viral resistance, it should be endeavored to develop better strategies in anti-CMV treatment. Moreover, blocking of the viral replication does not always resolve the manifestations which are often linked with CMV-associated immunopathomechanisms. Thus, the efficacy of the available drugs is also discussed in the light of their ability to modulate inflammatory components of the cell-mediated immune system.

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Treatment of Cytomegalovirus Retinitis with Intravitreous Cidofovir in Patients with AIDS: A Preliminary Report

Abstract: Treatment and subsequent maintenance of cytomegalovirus retinitis with 20 micrograms of intravitreously injected cidofovir, given at 5- to 6-week intervals, is safe and highly effective.

Cited by 44 publications

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Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Clinical Failure of CMV Retinitis With Intravitreal Cidofovir Is Associated With Antiviral Resistance

Treatment of Cytomegalovirus Retinitis: A Growing Number of Options

Treatment of Cytomegalovirus Diseases

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