Oral Ganciclovir as Maintenance Treatment for Cytomegalovirus Retinitis in Patients with AIDS

Drew, W. Lawrence; Ives, David V.; Lalezari, Jacob; Crumpacker, Clyde S.; Follansbee, Stephen; Spector, Stephen A.; Benson, Constance A.; Friedberg, Dorothy N.; Hubbard, Larry D.; Stempien, Mary Jean

doi:10.1056/nejm199509073331002

Cited by 268 publications

(65 citation statements)

References 24 publications

(21 reference statements)

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“…This resulted in a prolonged hospital admission that was further complicated by an episode of line sepsis, possibly related to the prolonged use of intravenous ganciclovir, which itself can cause myelosuppression. 4 This report demonstrates the difficulties that may be faced when managing CMV retinitis in severely immunocompromised patients who are slow to immune reconstitution. There is risk of recurrent CMV retinitis, the management of which is problematic as effective treatment is needed, whilst avoiding further complications of developing resistance and the adverse effects of antivirals.…”

mentioning

confidence: 89%

Management of cytomegalovirus retinitis in HIV infection in the era of highly active antiretroviral therapy

Timperley

Taha

2015

Int J STD AIDS

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mentioning

confidence: 89%

Management of cytomegalovirus retinitis in HIV infection in the era of highly active antiretroviral therapy

Timperley

Taha

2015

Int J STD AIDS

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“…• Once daily valganciclovir is the maintenance therapy of choice because it is effective (32,46) and it eliminates the dangers and inconvenience of IV administration (evidence grade IA) (32,34,35,37,46) (Table 5). …”

Section: Recommendationsmentioning

confidence: 99%

Canadian Consensus Guidelines for the Management of Cytomegalovirus Disease in HIV/AIDS

Lalonde¹,

Bovivin²,

Deschênes³

et al. 2004

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND: The management of HIV-infected patients with cytomegalovirus (CMV) disease has changed significantly with the availability of highly active antiretroviral therapy (HAART).OBJECTIVES: These updated guidelines are intended to provide practical help to physicians managing HIV-positive patients with or at risk for CMV disease.METHODS: The 10 members of the Canadian CMV Disease in HIV/AIDS Consensus Group were infectious disease specialists, a primary care physician and ophthalmologists with expertise in HIV and CMV infection. Financial support by Hoffmann-La Roche Canada Ltd was unrestricted, and was limited to travel expenses and honoraria. The consensus group met in June and October 2002. Key areas to be considered were identified, and group members selected, reviewed and presented relevant recent literature for their assigned section for the group's consideration. Evidence was assessed based on established criteria, which were expert opinions of the members. Draft documents were circulated to the entire group and modified until consensus was reached. The final guidelines represent the group's consensus agreement. The guidelines were approved by the Canadian Infectious Disease Society.RESULTS AND CONCLUSIONS: The guidelines address symptom monitoring, screening for early detection and prevention, and treatment using oral, intravenous and intraocular anti-CMV therapies in conjunction with HAART.

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“…Por VO se dispone de ganciclovir y de valganciclovir que es el éster de valina del ganciclovir. La biodisponibilidad del ganciclovir VO es muy pobre, lo que le resta eficacia con respecto al ganciclovir IV y obliga a los pacientes a tomar un gran número de comprimidos 20 . El valganciclovir, sin embargo, se metaboliza por enzimas del tubo digestivo y se transforma prácticamente en un 100% en ganciclovir 21 .…”

Section: Profilaxis Secundariaunclassified

Prevención de las infecciones oportunistas en pacientes adultos y adolescentes infectados por el VIH. Recomendaciones de GESIDA/Plan Nacional sobre el Sida. Año 2003

Berenguer¹,

Laguna²,

López‐Aldeguer³

et al. 2004

Enferm Infecc Microbiol Clin

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OBJETIVO. Actualización de las recomendaciones del Grupo de Estudio de Sida (GESIDA) y la Secretaría del Plan Nacional sobre el Sida (PNS) sobre prevención de las infecciones oportunistas en pacientes adultos y adolescentes infectados por el virus de la inmunodeficiencia humana (VIH).MÉTODOS. Las recomendaciones han sido consensuadas por un grupo de expertos de GESIDA y/o del PNS tras la revisión del antiguo documento y las aportaciones científicas sobre la materia de los últimos años. Para la clasificación de la fuerza y de la calidad de las recomendaciones se ha seguido el sistema utilizado por la Sociedad Americana de Enfermedades Infecciosas (IDSA) y el Servicio de Salud Pública de los Estados Unidos de América (USPHS). RESULTADOS. En este documento, se realiza una revisión pormenorizada de las medidas para prevenir las infecciones causadas por virus, bacterias, hongos y parásitos en el contexto de la infección por el VIH. Para cada grupo de patógenos se han dado recomendaciones para prevenir la exposición a los mismos, para las profilaxis primarias y para las profilaxis secundarias. También se han establecido unos criterios para la retirada de las profilaxis en pacientes que tienen una buena respuesta al tratamiento antirretroviral de gran actividad (TARGA). CONCLUSIONES. El TARGA es la mejor estrategia para prevenir las infecciones oportunistas en pacientes infectados por el VIH. Sin embargo, las profilaxis continúan siendo necesarias en los países con pocos recursos económicos, en pacientes muy

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Oral Ganciclovir as Maintenance Treatment for Cytomegalovirus Retinitis in Patients with AIDS

Abstract: Oral ganciclovir is safe and effective as maintenance therapy for cytomegalovirus retinitis and is more convenient for patients to take than intravenous ganciclovir.

Cited by 268 publications

References 24 publications

Management of cytomegalovirus retinitis in HIV infection in the era of highly active antiretroviral therapy

Management of cytomegalovirus retinitis in HIV infection in the era of highly active antiretroviral therapy

Canadian Consensus Guidelines for the Management of Cytomegalovirus Disease in HIV/AIDS

Prevención de las infecciones oportunistas en pacientes adultos y adolescentes infectados por el VIH. Recomendaciones de GESIDA/Plan Nacional sobre el Sida. Año 2003

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