CMV INFECTIONS IN AIDS PATIENTS ON ANTI-VIRAL CLINICAL PROTOCOLS

(1)项目目标：

(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.