No abstract

No abstract

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.

No abstract

No abstract