Treatment of serious cytomegalovirus infections with 9-(1,3-dihydroxy-2-propoxymethyl)guanine in patients with AIDS and other immunodeficiencies. Collaborative DHPG Treatment Study Group
The drug 9-(1,3-dihydroxy-2-propoxymethyl)-guanine (DHPG) was used to treat serious cytomegalovirus infections in 26 patients with underlying immunodeficiency (including 22 with the acquired immunodeficiency syndrome). In 17 of 22 patients in whom cytomegalovirus was virologically confirmed, clinical status improved or stabilized, although in 4 of them the status of some affected organs deteriorated or did not improve. Fourteen of 18 patients with adequate viral-culture data had clearing of cytomegalovirus from all cultured sites. Patients with cytomegalovirus pneumonia often responded poorly; four of seven died before completing 14 days of DHPG therapy. The condition of 11 of 13 patients with cytomegalovirus retinitis and 5 of 8 with gastrointestinal disease stabilized or improved. However, clinical and virologic relapses occurred in 11 of 14 patients (79 percent) when DHPG was discontinued. Neutropenia was the most frequent adverse reaction. We conclude that DHPG offers promise for the therapy of severe cytomegalovirus infections in some immunodeficient patients, but further study will be necessary to establish its efficacy and safety.
This article has been cited by other articles:
Adler, S. P., Marshall, B.
(2007). Cytomegalovirus Infections. Pediatr. Rev.
28: 92-100
[Full Text]
Lambert, E. M., Strasswimmer, J., Lazova, R., Antaya, R. J.
(2004). Cytomegalovirus Ulcer: Successful Treatment With Valganciclovir. Arch Dermatol
140: 1199-1201
[Full Text]
Prichard, M. N., Gao, N., Jairath, S., Mulamba, G., Krosky, P., Coen, D. M., Parker, B. O., Pari, G. S.
(1999). A Recombinant Human Cytomegalovirus with a Large Deletion in UL97 Has a Severe Replication Deficiency. J. Virol.
73: 5663-5670
[Abstract][Full Text]
Musch, D. C., Martin, D. F., Gordon, J. F., Davis, M. D., Kuppermann, B. D., The Ganciclovir Implant Study Group,
(1997). Treatment of Cytomegalovirus Retinitis with a Sustained-Release Ganciclovir Implant. NEJM
337: 83-90
[Abstract][Full Text]
Jacobson, M. A.
(1997). Treatment of Cytomegalovirus Retinitis in Patients with the Acquired Immunodeficiency Syndrome. NEJM
337: 105-114
[Full Text]
Nicklin, D., Wood, C. A., Pulido, F., Carnevali, D., Rubio, R., Spector, S. A., Stempien, M. J.
(1996). Oral Ganciclovir as Prophylaxis against Cytomegalovirus. NEJM
335: 1395-1397
[Full Text]
Crumpacker, C. S.
(1996). Ganciclovir. NEJM
335: 721-729
[Full Text]
Spector, S. A., McKinley, G. F., Lalezari, J. P., Samo, T., Andruczk, R., Follansbee, S., Sparti, P. D., Havlir, D. V., Simpson, G., Buhles, W., Wong, R., Stempien, M. J., The Roche Cooperative Oral Ganciclovir Study Group,
(1996). Oral Ganciclovir for the Prevention of Cytomegalovirus Disease in Persons with AIDS. NEJM
334: 1491-1497
[Abstract][Full Text]
Remuzzi, G., Gotti, E.
(1995). The Girl with the Curl. NEJM
333: 928-931
[Full Text]
D'Amico, D. J.
(1994). Diseases of the Retina. NEJM
331: 95-106
[Full Text]
Wheeler-Daigle, N., Altilio, D., Tierney, A. R., Kotler, D. P.
(1988). Letter to the Editor. Nutr Clin Pract
3: 171-172
