9 Nov 2009
"... Management: Immunocompromised patients (especially HIV)
1. Highly active Antiretroviral therapy (HAART) in HIV
1. Critical to prevent CMV organ involvement
2. Risk in HIV highest when CD4 Count <50/mm3
2. Indications for Viral DNA polymerase inhibitors
1. CMV Retinitis (Urgent therapy)
2. Clinically Significant colitis or other end-organ
3. Treatment of asymptomatic CMV not indicated
1. Granulocytopenia and Anemia risk (25%)
2. Foscarnet (Foscavir)
1. Nephrotoxicity (33%)
3. Electrolyte disturbance (Hypokalemia, Hypocalcemia)
3. Cidofovir (Vistide)
1. CMV Retinitis responds to 14-21 day in 75-90% cases
2. Patients failing one drug should move to the other
1. Cidofovir 5 mg/kg IV each week for 2 weeks
2. Chronic maintenance (prevents relapse in 4-8 weeks)
1. Cidofovir 5 mg/kg every other week"
Hope this is helpful.
See also http://www.drugs.com/mtm/cidofovir.html
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