Body mass repletion during ganciclovir treatment of cytomegalovirus infections in patients with acquired immunodeficiency syndrome.

Disseminated cytomegalovirus (CMV) infection is a common complication of acquired immunodeficiency syndrome and contributes significantly to its morbidity and mortality. Ganciclovir, a guanosine analogue, inhibits CMV replication in vitro and in vivo, and its use can stabilize the clinical course of an affected patient. We examined the changes in body composition that occurred in four untreated patients and in eight patients who were treated with ganciclovir for serious CMV infections. Untreated patients lost weight, depleted body cell mass, as determined from total-body potassium measurements in a whole-body counter, lost body fat, as estimated from anthropometric measurements, and had a progressive fall in serum albumin concentration. In contrast, treated patients gained weight, repleted body cell mass and body fat, and increased serum albumin concentration during a three-month follow-up. In this study, it was estimated that ganciclovir therapy resulted in a net energy conservation of 2629 kJ/d. The ability to promote body cell mass repletion may be considered a demonstration of the efficacy of ganciclovir in the treatment of serious CMV infections in patients with acquired immunodeficiency syndrome.