TY - JOUR
T1 - Emergence of Drug-Resistant Cytomegalovirus Retinitis in the Contralateral Eyes of Patients with AIDS Treated with Ganciclovir
AU - Imai, Yumi
AU - Shum, Carol
AU - Martin, Daniel F.
AU - Kuppermann, Baruch D.
AU - Drew, W. Lawrence
AU - Margolis, Todd P.
PY - 2004/2/15
Y1 - 2004/2/15
N2 - The purpose of the present study was to examine the emergence of ganciclovir-resistant virus in the contralateral eyes of patients who received treatment for cytomegalovirus retinitis with either a ganciclovir implant plus oral placebo, a ganciclovir implant plus oral ganciclovir, or intravenous (iv) ganciclovir. Viral DNA was amplified from vitreous specimens and was assayed for UL97 and UL54 resistance mutations. Resistant viral genotypes were found in the contralateral eyes of 0 of 28 patients treated with a ganciclovir implant plus oral placebo, in 5 of 23 patients treated with a ganciclovir implant plus oral ganciclovir, and in 1 of 6 patients treated with iv ganciclovir. All resistance mutations were in codons 591, 592, or 594 of the UL97 gene. Treatment of unilateral cytomegalovirus retinitis with systemic ganciclovir decreases the risk of development of secondary sites of infection, but, in contralateral eyes that develop retinitis, this approach to treatment is associated with a higher prevalence of drug resistance, compared with treatment with the ganciclovir implant alone (P = .023; Fisher's exact test).
AB - The purpose of the present study was to examine the emergence of ganciclovir-resistant virus in the contralateral eyes of patients who received treatment for cytomegalovirus retinitis with either a ganciclovir implant plus oral placebo, a ganciclovir implant plus oral ganciclovir, or intravenous (iv) ganciclovir. Viral DNA was amplified from vitreous specimens and was assayed for UL97 and UL54 resistance mutations. Resistant viral genotypes were found in the contralateral eyes of 0 of 28 patients treated with a ganciclovir implant plus oral placebo, in 5 of 23 patients treated with a ganciclovir implant plus oral ganciclovir, and in 1 of 6 patients treated with iv ganciclovir. All resistance mutations were in codons 591, 592, or 594 of the UL97 gene. Treatment of unilateral cytomegalovirus retinitis with systemic ganciclovir decreases the risk of development of secondary sites of infection, but, in contralateral eyes that develop retinitis, this approach to treatment is associated with a higher prevalence of drug resistance, compared with treatment with the ganciclovir implant alone (P = .023; Fisher's exact test).
UR - http://www.scopus.com/inward/record.url?scp=1442325329&partnerID=8YFLogxK
U2 - 10.1086/381394
DO - 10.1086/381394
M3 - Article
C2 - 14767813
AN - SCOPUS:1442325329
SN - 0022-1899
VL - 189
SP - 611
EP - 615
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -