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Foscarnet Therapy of Cytomegalovirus Retinitis in AIDS

1990; Lippincott Williams & Wilkins; Volume: 3; Issue: 5 Linguagem: Inglês

10.1097/00126334-199003050-00002

1944-7884

Mary M. Fanning, Stanley Read, Martin Benson, S. Vas, Anita Rachlis, V. Kozousek, C Mortimer, P.Robert C. Harvey, C. Schwartz, Emily Y. Chew, Janet A. Brunton, A G Matlow, Irving E. Salit, H Vellend, Sharon Walmsley,

Neurological Complications and Syndromes

Cytomegalovirus (CMV) retinitis is the most common cause of blindness in AIDS. Twenty patients were treated with a 21-day course of foscarnet therapy by continuous infusion. Response to therapy was good in eight (47%) of 17 evaluable patients; partial arrest of progression was observed in eight (47%); and no response was obtained in one (6%). Foscarnet therapy did not lead to suppression of urinary excretion of CMV in four of 12 patients who nonetheless had improvement in retinal lesions. Toxic effects, especially reversible renal failure, were common, with blood creatinine increase in 50% and dialysis in two patients. Renal toxicity occurred primarily during the third week of therapy. Anemia (hemoglobin 24 weeks). Toxicity on the maintenance protocol included anemia (two of seven patients) and increased creatinine blood levels (one of seven patients). Zidovudine therapy in six patients did not contribute to increased toxicity of induction or maintenance therapy. Drug levels during continuous infusion were stable for individual patients but showed wide inter-patient variability. Peak levels of post-maintenance infusion varied both within and between patients.