DETECTION OF HUMAN CYTOMEGALOVIRUS INFECTIONS

监测血液、尿液、咽喉和组织标本， 巨细胞病毒（CMV）的存在对于确定 人类免疫缺陷病毒感染者的临床状况 (HIV 1）。我们目前正在研究实验性疗法的患者， HIV 1感染和艾滋病相关的机会性感染（如CMV）， 确定原发性感染的治疗是否导致CMV的变化 status.膦甲酸（膦甲酸三钠）是一种抗病毒剂， 对疱疹病毒（包括CMV）和HIV 1的体外活性。我们 目前正在参与一项随机试验的艾滋病患者与CMV 视网膜炎，以确定膦甲酸加AZT的毒性和疗效 联合治疗似乎立即用膦甲酸钠治疗 在延缓CMV进展方面比延迟治疗更有效 视网膜炎巨细胞病毒血症在1周内清除，病毒尿在2周内清除。 诱导疗法还记录了p24抗原水平的降低。 膦甲酸具有抗CMV和抗HIV活性，可能成为一种重要的 治疗艾滋病患者的CMV视网膜炎。此外，还进行了一次审判， 开始比较膦甲酸和更昔洛韦治疗艾滋病患者的效果 CMV视网膜炎 在一项单独的体外研究中，我们测试了两种药物，膦甲酸和 更昔洛韦单独和联合用于其抗CMV病毒抑制 方面的影响. 结果发现，两种药物联合使用具有协同作用， 对CMV复制的抑制作用。这些体外研究结果可能导致 用这种药物组合治疗患者， 剂量的个别药物，从而减少药物相关的 毒性，同时获得相当水平的抗病毒活性。

The monitoring of blood, urine, throat, and tissue specimens for the presence of cytomegalovirus (CMV) is important for determining changes in the clinical status of patients infected with human immunodeficiency virus (HIV 1). We are currently studying patients on experimental therapies for HIV 1 infection and AIDS related opportunistic infections (such as CMV) to determine if treatment of the primary infections results in changes in CMV status. Foscarnet (trisodium phosphonoformate) is an antiviral agent with in vitro activity against both herpesviruses (including CMV), and HIV 1. We are currently participating in a randomized trial of AIDS patients with CMV retinitis, to determine the toxicity and efficacy of foscarnet plus AZT combination treatment. It appears that immediate treatment with foscarnet is more effective than delayed therapy in postponing progression of CMV retinitis. CMV vinemia cleared in 1 week and viruria in 2 weeks on induction therapy. A decrease in p24 antigen levels was also documented. With both anti-CMV and anti-HIV activity, foscarnet may become an important treatment of CMV retinitis in patients with AIDS. In addition, a trial was initiated to compare foscarnet and ganciclovir treatments in AIDS patients with CMV retinitis. In a separate in vitro study, we tested two drugs, foscarnet and gancyclovir separately and in combination for their anti CMV virostatic effects. It was found that the combination of the two drugs has a synergistic inhibitory effect on CMV replication. These in vitro findings may result in patient treatment with this drug combination allowing for use of reduced doses of the individual drugs and thus reducing the drug associated toxicity while obtaining a comparable level of antiviral activity.