Foscarnet therapy of cytomegalovirus retinitis in AIDS

M. M. Fanning, S. E. Read, M. Benson, S. Vas, A. Rachlis, V. Kozousek, C. Mortimer, P. Harvey, C. Schwartz, E. Chew, J. Brunton, A. Matlow, I. Salit, H. Vellend, S. Walmsley

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Abstract

Cytomegalovirus (CMV) retinitis is the most common cause of blindness in AIDS. Twenty patients were treated with a 21-day course of foscarnet therapy by continuous infusion. Response to therapy was good in eight (47%) of 17 evaluable patients; partial arrest of progression was observed in eight (47%); and no response was obtained in one (6%). Foscarnet therapy did not lead to suppression of urinary excretion of CMV in four of 12 patients who nonetheless had improvement in retinal lesions. Toxic effects, especially reversible renal failure, were common, with blood creatinine increase in 50% and dialysis in two patients. Renal toxicity occurred primarily during the third week of therapy. Anemia (hemoglobin <80 g/L) occurred in 10 patients after a mean of 14.5 ± 5.1 days of therapy and required transfusion. Review of this study and of data from a previous case series, however, was inconclusive regarding the additional benefit of a third week of therapy. Maintenance therapy was given to seven patients. Four had recurrence of CMV retinitis at a mean interval of 62 ± 52 days. Only one patient has maintained prolonged remission on maintenance (>24 weeks). Toxicity on the maintenance protocol included anemia (two of seven patients) and increased creatinine blood levels (one of seven patients). Zidovudine therapy in six patients did not contribute to increased toxicity of induction or maintenance therapy. Drug levels during continuous infusion were stable for individual patients but showed wide interpatient variability. Peak levels of post-maintenance infusion varied both within and between patients. Key Words: Cytomegalovirus—Retinitis—Foscarnet.

Original languageEnglish
Pages (from-to)472-479
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume3
Issue number5
Publication statusPublished - May 1990

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ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Fanning, M. M., Read, S. E., Benson, M., Vas, S., Rachlis, A., Kozousek, V., Mortimer, C., Harvey, P., Schwartz, C., Chew, E., Brunton, J., Matlow, A., Salit, I., Vellend, H., & Walmsley, S. (1990). Foscarnet therapy of cytomegalovirus retinitis in AIDS. Journal of Acquired Immune Deficiency Syndromes, 3(5), 472-479.