American Journal of Ophthalmology
Volume 135, Issue 1 , Pages 26-34 , January 2003

Cytomegalovirus resistance to ganciclovir and clinical outcomes of patients with cytomegalovirus retinitis

  • Douglas A Jabs, MD, MBA

      Affiliations

    • Corresponding Author InformationInquiries to Douglas A. Jabs, MD, MBA, 550 North Broadway, Suite 700, Baltimore, MD 21205, USA; fax: (410) 955-0629
    • Department of Ophthalmology (D.A.J., J.P.D, J.H.K.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • Department of Medicine (D.A.J.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • Department of Epidemiology (D.A.J., B.K.M., J.H.K.), The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
    • ,
  • Barbara K Martin, PhD

      Affiliations

    • Department of Epidemiology (D.A.J., B.K.M., J.H.K.), The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
    • ,
  • Michael S Forman, MS

      Affiliations

    • Department of Pathology (M.S.F.), The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
    • ,
  • Larry Hubbard (MAT)

      Affiliations

    • Department of Ophthalmology (L.H.), University of Wisconsin at Madison School of Medicine, Madison, Wisconsin, USA
    • ,
  • J.P Dunn, MD

      Affiliations

    • Department of Ophthalmology (D.A.J., J.P.D, J.H.K.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • ,
  • John H Kempen, MD, PhD

      Affiliations

    • Department of Ophthalmology (D.A.J., J.P.D, J.H.K.), The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    • Department of Epidemiology (D.A.J., B.K.M., J.H.K.), The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
    • ,
  • Janet L Davis, MD

      Affiliations

    • Department of Ophthalmology (J.L.D.), University of Miami, Miami, Florida, USA
    • ,
  • David V Weinberg, MD

      Affiliations

    • Department of Ophthalmology (D.V.W.), Northwestern University School of Medicine, Chicago, Illinois, USA
    • ,
  • Cytomegalovirus Retinitis and Viral Resistance Study Group

      Affiliations

,Accepted 1 May 2002.

References 

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  2. Pertel P, Hirschtick RE, Phair J, Chmiel JS, Poggensee L, Murphy R. Risk of developing cytomegalovirus retinitis in persons infected with the human immunodeficiency virus. J Acquir Immune Defic Syndr. 1992;5:1069–1074
  3. Zidovudine Epidemiology Group Gallant JE, Moore RD, Richman DD, Keruly J, Chaisson RE. Incidence and natural history of cytomegalovirus disease in patients with advanced human immunodeficiency virus disease treated with zidovudine. J Infect Dis. 1992;166:1223–1227
  4. Hoover DR, Peng Y, Saah A, et al.  Occurrence of cytomegalovirus retinitis after human immunodeficiency virus immunosuppression. Arch Ophthalmol. 1996;114:821–827
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  7. Holtzer CD, Jacobson MA, Hadley WK, et al.  Decline in the rate of specific opportunistic infections at San Francisco General Hospital, 1994-1997. AIDS. 1998;12:1931–1933
  8. Jacobson AJ, Stanley H, Holtzer C, Margolis TP, Cunningham ET. Natural history and outcome of new AIDS-related cytomegalovirus retinitis diagnosed in the era of highly active antiretroviral therapy. Clin Infect Dis. 2000;30:232–233
  9. Jabs DA, Enger C, Bartlett JG. Cytomegalovirus retinitis and acquired immunodeficiency syndrome. Arch Ophthalmol. 1989;107:75–80
  10. Cytomegalovirus Retinitis and Viral Resistance Study Group Jabs DA, Enger C, Dunn JP, Forman M. Cytomegalovirus resistance and viral resistance (4. Ganciclovir resistance). J Infect Dis. 1998;177:770–773
  11. Cytomegalovirus Retinitis and Viral Resistance Study Group Jabs DA, Enger C, Forman M, Dunn JP. Incidence of foscarnet resistance and cidofovir resistance in patients treated for cytomegalovirus retinitis. Antimicrob Agents Chemother. 1998;42:2240–2244
  12. Dunn JP, MacCumber MW, Forman MS, Charache P, Apuzzo L, Jabs DA. Viral sensitivity testing in patients with cytomegalovirus retinitis clinically resistant to foscarnet or ganciclovir. Am J Ophthalmol. 1995;119:587–596
  13. Jabs DA, Martin BK, Forman MS, et al.  Longitudinal observations on mutations conferring ganciclovir resistance in patients with acquired immune deficiency syndrome and cytomegalovirus retinitis (the Cytomegalovirus and Viral Resistance Study Group Report Number 8). Am J Ophthalmol. 2001;132:700–710
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  16. Arevalo JF, Gonzalez C, Capparelli EV. Intravitreous and plasma concentrations of ganciclovir and foscarnet after intravenous therapy in patients with AIDS and cytomegalovirus retinitis. J Infect Dis. 1995;172:951–956
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  24. Studies of Ocular Complications of AIDS Research Group in Collaboration with the AIDS Clinical Trials Group . Combination foscarnet and ganciclovir therapy versus monotherapy for the treatment of relapsed cytomegalovirus retinitis in patients with AIDS. The Cytomegalovirus Retreatment Trial. Arch Ophthalmol. 1996;114:23–33
  25. Studies of Ocular Complications of AIDS Research Group in Collaboration with the AIDS Clinical Trials Group . Cytomegalovirus (CMV) culture results, drug resistance, and clinical outcome in patients with AIDS and CMV retinitis treated with foscarnet or ganciclovir. J Infect Dis. 1997;176:50–58
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  28. Torriani FJ, Freeman WR, MacDonald JC, et al.  CMV retinitis recurs after stopping treatment in virological and immunologic failures of potent antiretroviral therapy. AIDS. 2000;14:173–180
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  30. Martin DF, Kuppermann BD, Wolitz RA, Palestine AG, Li H, Robinson CA. Oral ganciclovir for patients with cytomegalovirus retinitis treated with a ganciclovir implant. Roche Ganciclovir Study Group. N Engl J Med. 1999;340:1063–1070
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  34. SOCA Research Group Holbrook JT, Meinert CL, Van Natta ML, Davis M, Hubbard L, Jabs DA. Photographic measures of cytomegalovirus retinitis as surrogates for visual outcomes in treated patients. Arch Ophthalmol. 2001;119:554–563
  35. Kempen JH, Jabs DA, Dunn JP, West SK, Tonascia J. Retinal detachment risk in cytomegalovirus retinitis related to the acquired immune deficiency syndrome. Arch Ophthalmol. 2001;119:33–40
  36. Studies of Ocular Complications of AIDS Research Group in Collaboration with the AIDS Clinical Trials Group . 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). Am J Ophthalmol. 2001;131:457–467
  37. Cytomegalovirus Retinitis and Viral Resistance Study Group Jabs DA, Forman M, Enger C, Jackson JB. Comparison of cytomegalovirus loads in plasma and leukocytes of patients with cytomegalovirus retinitis. J Clin Microbiol. 1999;37:1431–1435

☆ This study was supported by Grant EY-10268 (D.A.J.) from the National Eye Institute, National Institutes of Health, Bethesda, Maryland; and by NIH/National Center for Research Resources Grant M01-RR00052 to The Johns Hopkins University School of Medicine.

☆☆ InternetAdvance publication at ajo.com Sept 6, 2002.

PII: S0002-9394(02)01759-2

American Journal of Ophthalmology
Volume 135, Issue 1 , Pages 26-34 , January 2003

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