Suppression of cytomegalovirus retinitis in persons with AIDS with high-dose intravenous acyclovir

AIDS is caused by infection with the human immunodeficiency virus (HIV). The virus attacks and destroys the immune system, resulting in immunodeficiency or decreased ability to fight infection. People who develop AIDS are more susceptible to opportunistic infections which do not usually affect individuals with normal immune function. Eye infection due to cytomegalovirus (CMV) is common in patients with AIDS. CMV retinitis (inflammation of the retina) is estimated to occur in 6 to 40 percent of this patient population. At present, foscarnet and ganciclovir are the only drugs that have been shown to be effective in treating CMV retinitis. However, foscarnet is not commercially available in the United States, and prolonged treatment with ganciclovir has been reported to cause neutropenia (abnormally low number of white blood cells known as neutrophils). Acyclovir is an antiviral drug that has been used to treat infections with herpes simplex virus and Epstein-Barr virus. This drug has also been shown to be beneficial in treating transplant patients who develop CMV infections. A study was performed to determine if high doses of intravenously administered acyclovir could be effective in treating CMV retinitis in AIDS patients. Twelve men with AIDS and CMV retinitis were treated with ganciclovir for 12 to 14 days. Following this treatment, the patients received daily treatments with acyclovir and zidovudine (AZT). For half the patients retinitis did not progress during 32 days or more of acyclovir and AZT treatment. During the study period, 10 patients who were evaluated did not develop CMV retinitis in the uninfected eye. In a previous study, retinitis spread from one eye to the other in 60 percent of the patients. These findings indicate that, in patients with AIDS, acyclovir may be beneficial for delaying the progression of CMV retinitis and preventing the spread of retinitis to the unaffected eye. (Consumer Summary produced by Reliance Medical Information, Inc.)