艾滋病患者巨细胞病毒性视网膜炎治疗的治疗算法。圆桌会议总结。

Therapeutic algorithm for treatment of cytomegalovirus retinitis in persons with AIDS. A roundtable summary.

作者信息

Balfour H H, Drew W L, Hardy W D, Heinemann M H, Polsky B

机构信息

Department of Laboratory Medicine, University of Minnesota Health Sciences Center, Minneapolis.

出版信息

J Acquir Immune Defic Syndr (1988). 1992;5 Suppl 1:S37-44.

PMID:1318367

Abstract

Foscarnet and ganciclovir appear to be of similar effectiveness in halting active infection when given as induction therapy and in forestalling progression of disease when given as maintenance therapy in persons with AIDS who have cytomegalovirus (CMV) retinitis. The primary dose-limiting toxicity of foscarnet is nephrotoxicity, whereas that of ganciclovir is neutropenia. The availability of two effective agents with different toxicities permits selection of initial treatment for CMV retinitis based on individual patient characteristics and provides an alternative for therapy if drug intolerance or viral resistance develops. An approach to treatment of first-episode and recurrent CMV retinitis based on patient and drug characteristics is presented. Case reports detailing the use of foscarnet and ganciclovir and problems encountered in patient management are discussed.

摘要

对于患有巨细胞病毒（CMV）视网膜炎的艾滋病患者，膦甲酸和更昔洛韦在作为诱导疗法使用时，在阻止活动性感染方面似乎具有相似的疗效；在作为维持疗法使用时，在预防疾病进展方面也具有相似的疗效。膦甲酸的主要剂量限制性毒性是肾毒性，而更昔洛韦的主要剂量限制性毒性是中性粒细胞减少。有两种具有不同毒性的有效药物可供选择，这使得可以根据患者的个体特征选择CMV视网膜炎的初始治疗方法，并且如果出现药物不耐受或病毒耐药性，还可以提供替代治疗方案。本文介绍了一种基于患者和药物特征的初发性和复发性CMV视网膜炎的治疗方法。文中讨论了详细描述膦甲酸和更昔洛韦使用情况以及患者管理中遇到问题的病例报告。