Cytomegalovirus retinitis in persons with AIDS--a shift in the treatment paradigm?
Cytomegalovirus retinitis in persons with AIDS--a shift in the treatment paradigm?
复制标题
艾滋病患者的巨细胞病毒性视网膜炎——治疗模式的转变？
DOI：
10.1086/515168
复制
发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Polis,MA
中科院分区：
文献类型：
--
作者：
Polis,MA
Cytomegalovirus (CMV) retinitis is the most common intraocular infection in patients with AIDS [1-3]. Before the widespread use of potent antiretroviral therapy, CMV retinitis oc-curred in up to 40% of patients during the course of their disease [3-6], usually when CD4+ cell counts were< 100//pL [2, 3, 5]. Before the availability of ganciclovir in 1988, CMV retinitis was relentlessly progressive, leading to loss of vision and often foreshadowing an early death [4]. Without therapy, CMV retinitis leads to diffuse retinal necrosis and blindness, with a median time from detection of active CMV retinitis to progression of disease in severely immunosuppressed patients of 2 to 3 weeks [7-9]. Standard maintenance therapy for CMV retinitis is daily parenteral administration of ganciclovir or foscamet, biweekly parenteral administration of cidofovir, thrice daily oral ganciclovir, or the surgical implantation of a sustained-release ganciclovir implant into the eye with or with-out associated oral ganciclovir [10]. Treatment is costly and associated with a plethora of adverse effects; the wholesale acquisition drug costs alone of these treatment options (without surgical, administration, monitoring, or catheter care costs) have been estimated to range from $5,000 to $37,200 annually [11]. Toxicities include bone marrow suppression, electrolyte imbalances, and renal insufficiency.
