+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Foscarnet treatment of cytomegalovirus gastrointestinal infections in acquired immunodeficiency syndrome patients who have failed ganciclovir induction



Foscarnet treatment of cytomegalovirus gastrointestinal infections in acquired immunodeficiency syndrome patients who have failed ganciclovir induction



American Journal of Gastroenterology 88(4): 542-548



This compassionate-use study examined the efficacy of foscarnet in patients with AIDS and cytomegalovirus (CMV) gastrointestinal disease who had failed ganciclovir induction. Nineteen male homosexuals with AIDS and biopsy-proven CMV gastrointestinal disease who had twice failed standard ganciclovir induction (defined as progression of clinical CMV disease) were studied. Foscarnet 60 mg/kg every 8 h was administered intravenously for 14 days, then maintenance was utilized at 90 or 120 mg/kg every day with 1 L normal saline daily. Endpoints included endoscopic appearance, blinded histopathologic analysis of biopsies for CMV inclusions, and changes in symptoms by 50% from baseline. Patients were evaluated before and 2-3 wk after foscarnet. Histopathologic improvement was seen in 67%, whereas 74% improved clinically after a median duration of 7.5 days (1-12). Among the nine with esophageal disease, six patients (68%) had a clinical response and six of eight (75%) had a pathologic response. Among the 10 with colonic disease, eight patients (80%) had a clinical response and six (60%) had a pathologic response. Reversible elevations in creatinine were seen in two of 17 (12%). Three patients with esophageal disease developed strictures late in therapy requiring dilation. Median survival after foscarnet induction was 5.0 months. Foscarnet appears to induce remission of CMV gastrointestinal disease in 67% of patients when ganciclovir induction has failed. Reversible nephrotoxicity occurred in 12%. Strictures may be a late complication of CMV esophagitis.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 008701276

Download citation: RISBibTeXText

PMID: 8385880


Related references

Foscarnet treatment of cytomegalovirus gastrointestinal infections in hiv patients who have failed ganciclovir. Gastroenterology 100(5 Part 2): A575, 1991

Foscarnet treatment of cytomegalovirus gastrointestinal infections in aids patients who have failed ganciclovir. Istituto Superiore Di Sanita Vii International Conference on Aids: Science Challenging Aids; Florence, Italy, June 16-21, 464p (Vol 1); 460p (Vol 2) Istituto Superiore Di Sanita: Rome, Italy Paper : 255b, 1991

Combination ganciclovir and foscarnet in the treatment of clinically resistant cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. Archives of Ophthalmology 111(10): 1359-1366, 1993

Combined treatment with ganciclovir and foscarnet for cytomegalovirus retinitis in a patient with acquired immunodeficiency syndrome. Rinsho Ganka 52(5): 803-806, 1998

Ocular complications of the acquired immunodeficiency syndrome. Focus on the treatment of cytomegalovirus retinitis with ganciclovir and foscarnet. Pharmacy World and Science 15(2): 56-67, 1993

Quantitative systemic and local evaluation of the antiviral effect of ganciclovir and foscarnet induction treatment on human cytomegalovirus gastrointestinal disease of patients with AIDS. Italian Foscarnet GID Study Group. Antiviral Research 34(1): 39-50, 1997

Intravitreal antiviral drug concentration after intravenous ganciclovir and foscarnet in acquired immunodeficiency syndrome patients with cytomegalovirus retinitis. Investigative Ophthalmology and Visual Science 35(4): 1892, 1994

Concurrent ganciclovir and foscarnet treatment for cytomegalovirus encephalitis and retinitis in an infant with acquired immunodeficiency syndrome: case report and review. Pediatric Infectious Disease Journal 16(8): 807-811, 1997

Therapy with a combination of intravitreal foscarnet and intravenous ganciclovir in clinically resistant cytomegalovirus retinitis and patients with acquired immunodeficiency syndrome. German Journal of Ophthalmology 5(6): 490-491, 1996

Body mass repletion during ganciclovir treatment of cytomegalovirus infections in patients with acquired immunodeficiency syndrome. Archives of Internal Medicine 149(4): 901-905, 1989

The ganciclovir implant plus oral ganciclovir versus parenteral cidofovir for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome: The Ganciclovir Cidofovir Cytomegalovirus Retinitis Trial. American Journal of Ophthalmology 131(4): 457-467, 2001

A randomized controlled study of foscarnet vs ganciclovir in induction therapy of cytomegalovirus gastrointestinal infections in AIDS. IXTH INTERNATIONAL CONFERENCE ON AIDS and THE IVTH STD WORLD CONGRESS Author IXth International Conference on AIDS in affiliation with the IVth STD World Congress : 54, 1993

9-(1,3-Dihydroxy-2-propoxymethyl)guanine (ganciclovir) in the treatment of cytomegalovirus gastrointestinal disease with the acquired immunodeficiency syndrome. Annals of Internal Medicine 107(2): 133-137, 1987

Treatment of cytomegalovirus esophagitis in patients with acquired immune deficiency syndrome: a randomized controlled study of foscarnet Versus ganciclovir. American Journal of Gastroenterology 93(3): 317-322, 1998

Foscarnet treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. Antimicrobial Agents and ChemoTherapy 33(5): 736-741, 1989