CMV INFECTIONS IN AIDS PATIENTS ON ANTI-VIRAL CLINICAL PROTOCOLS

(1)项目目标： -由于CMV被认为是主要的机会性感染之一 对于艾滋病患者，监测血液、尿液和组织是很重要的 来自参加各种临床试验的患者的样本 出现巨细胞病毒。 -确定巨细胞病毒敏感性的标准化化验方法 对各种药物都有分离物。 -开发基于流式细胞术的快速检测系统，以 测定CMV初分离株对抗病毒药物的敏感性 毒品。 -我们的实验室参与NIAID/ACTG共病原体的工作 巨细胞病毒病毒载量测定标准化小组委员会 在全国各地。 (2)临床方案的主题： (A)针对艾滋病毒-1的联合疗法：AZT/IL2、干扰素-α/IL2和 AZT、干扰素和AZT/干扰素联合应用的三臂试验 (B)确定巨细胞病毒免疫球蛋白疗效的随机双盲试验 作为预防艾滋病患者巨细胞病毒感染的药物。手稿在 准备工作。 (C)用于预防的胞嘧啶衍生物(HPMPC)第一阶段试验 和/或治疗艾滋病患者的巨细胞病毒感染。出版：(1) M.Polis等人。1955年。抗巨细胞病毒活性和安全性的研究 西托福韦在人类HIV感染和CMV病毒尿症患者中的应用 抗菌药和化疗39：882。 (D)腺嘌呤类似物(PMEA)作为潜在药物的第一阶段试验 对HIV-1和疱疹病毒的双重抗病毒作用。(病人 人口：艾滋病患者200人)。研究被终止。 (E)这个项目的另一个目标是确定是否可以分离出CMV 从无症状的和无症状的 有症状的HIV-1患者。它可能会提供早期的指标 在这些患者中重新激活CMV，并导致早期启动 抗巨细胞病毒治疗，预防全身性暴发性疾病。手稿 在准备中。

(1) Goals of Project: - Since CMV is recognized as one of the leading opportunistic infections in AIDS patients, it is important to monitor blood, urine, and tissue specimens from patients enrolled in various clinical trials for the presence of CMV. - Standardization of assays to determine the susceptibility of CMV isolates to various drugs. - Development of a rapid detection system based on Flow cytometry to determine the susceptibility of CMV primary isolates to anti-viral drugs. - Our laboratory participates in the NIAID/ACTG co-pathogen working group committee for the standardization of CMV viral burden assays around the country. (2) Subjects of Clinical Protocols: (a) Combination therapies against HIV-1 : AZT/IL2, IFN-alpha /IL2, and a three arm trial of combination AZT, IFN, and AZT/IFN. (b) A randomized double blind trial to determine the efficacy of CMV-IG as prophylaxis for CMV infections in AIDS patients. Manuscript in preparation. (c) Phase I trial with a Cytosine derivative (HPMPC) for the prevention and/or treatment of CMV infections in AIDS patients. Publication: (1) M. Polis et al. 1955. Anticytomegaloviral activity and safety of Citofovir in patients with human HIV infection and CMV viruria. Antimicrobial Agents and Chemotherapy 39: 882. (d) Phase I trial of an Adenine analog (PMEA) as a potential drug with dual anti- viral effects on HIV-1 and Herpes viruses. (patient population: AIDS with CD4 < 200). Study was terminated. (e) Another goal of this project is to determine if CMV can be isolated from bronchial lavage specimens taken from asymptomatic as well as symptomatic HIV-1 patients. It may provide an early indicator of reactivated CMV in these patients, and lead to early initiation of anti-CMV treatment to prevent systemic fulminating disease. Manuscript in preparation.