Shepp D H, Dandliker P S, de Miranda P, Burnette T C, Cederberg D M, Kirk L E, Meyers J D
Ann Intern Med. 1985 Sep;103(3):368-73. doi: 10.7326/0003-4819-103-3-368.
Ten marrow transplant recipients with biopsy-proven cytomegalovirus pneumonia were treated with the acyclic nucleoside analog 9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl]guanine (BW B759U). Viruria and viremia ceased after 4 days of treatment in all patients with cultures initially positive from these sites. Cytomegalovirus was eliminated from respiratory secretions after a median of 8 days. Despite this antiviral effect, only one patient survived the pneumonia. Quantitative cultures of lung tissue before and after treatment confirmed that therapy with BW B759U was associated with substantial antiviral activity, with a mean decrease in viral titers of more than 99.99% after treatment. Neutropenia developed in three patients when mean peak and trough plasma levels exceeded 50 and 10 mu mol/L, respectively, but no other toxicity was seen. BW B759U is the first antiviral agent showing consistent activity against cytomegalovirus in vivo, and it should be evaluated in the earlier management of cytomegalovirus infections after marrow transplantation and in serious cytomegalovirus infections in other immunocompromised patients.
10例经活检证实患有巨细胞病毒肺炎的骨髓移植受者接受了无环核苷类似物9-[2-羟基-1-(羟甲基)乙氧基甲基]鸟嘌呤（BW B759U）治疗。所有最初这些部位培养阳性的患者在治疗4天后病毒尿症和病毒血症均停止。中位8天后巨细胞病毒从呼吸道分泌物中清除。尽管有这种抗病毒作用，但只有1例患者从肺炎中存活。治疗前后肺组织的定量培养证实，BW B759U治疗具有显著的抗病毒活性，治疗后病毒滴度平均下降超过99.99%。当平均峰浓度和谷浓度分别超过50和10 μmol/L时，3例患者出现中性粒细胞减少，但未观察到其他毒性反应。BW B759U是第一种在体内对巨细胞病毒显示出持续活性的抗病毒药物，应在骨髓移植后巨细胞病毒感染的早期治疗以及其他免疫功能低下患者的严重巨细胞病毒感染中进行评估。
