       Document 0767
 DOCN  M9640767
 TI    Controversies in the treatment of cytomegalovirus retinitis: foscarnet
       versus ganciclovir.
 DT    9604
 AU    Jabs DA; Wilmer Ophthalmological Institute, Baltimore, Maryland 21205,;
       USA.
 SO    Infect Agents Dis. 1995 Sep;4(3):131-42. Unique Identifier : AIDSLINE
       MED/96034255
 AB    Cytomegalovirus (CMV) retinitis is the most common intraocular infection
       in patients with AIDS. Untreated, CMV retinitis is a binding disease.
       Ganciclovir, a nucleoside analog, and foscarnet, a pyrophosphate analog,
       are both effective in controlling CMV retinitis. A randomized,
       controlled, comparative trial of foscarnet and ganciclovir demonstrated
       that they were equivalent in terms of controlling CMV retinits, but that
       foscarnet was associated with a longer survival, possibly due to an
       antiretroviral effect of foscarnet. However, foscarnet was less well
       tolerated than ganciclovir, primarily due to the nature of its side
       effects. Because foscarnet and ganciclovir have different side effects,
       initial treatment of CMV retinitis should be individualized. Newer
       technological developments, including oral ganciclovir and the
       ganciclovir intraocular device, may influence the choice of initial
       treatment, particularly because of their effect on the quality of life
       when compared to chronic intravenous therapy. The occurrence of relapse
       and the development of resistance remain long-term concerns, which may
       alter the use of anti-CMV drugs over time.
 DE    Antiviral Agents/ADVERSE EFFECTS/*THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/*DRUG THERAPY/EPIDEMIOLOGY/  ETIOLOGY  Clinical
       Trials  Comparative Study  Cytomegalovirus Retinitis/*DRUG
       THERAPY/EPIDEMIOLOGY/ETIOLOGY  Foscarnet/ADVERSE EFFECTS/*THERAPEUTIC
       USE  Fundus Oculi  Ganciclovir/ADVERSE EFFECTS/*THERAPEUTIC USE  Human
       Randomized Controlled Trials  United States/EPIDEMIOLOGY  Vision
       JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

