Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Treating HIV-associated cytomegalovirus retinitis with oral valganciclovir and intra-ocular ganciclovir by primary HIV clinicians in southern Myanmar: a retrospective analysis of routinely collected data.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: London : BioMed Central, [2001-
    • الموضوع:
      Cytomegalovirus*; AIDS-Related Opportunistic Infections/*epidemiology ; Antiviral Agents/*therapeutic use ; Cytomegalovirus Retinitis/*drug therapy ; Cytomegalovirus Retinitis/*epidemiology ; Ganciclovir/*therapeutic use ; Valganciclovir/*therapeutic use; AIDS-Related Opportunistic Infections/virology ; Administration, Oral ; Adult ; Antiviral Agents/administration & dosage ; Antiviral Agents/adverse effects ; Cytomegalovirus Retinitis/virology ; Female ; Ganciclovir/administration & dosage ; Ganciclovir/adverse effects ; HIV ; Humans ; Injections, Intraocular ; Male ; Middle Aged ; Myanmar/epidemiology ; Primary Health Care ; Retrospective Studies ; Treatment Outcome ; Valganciclovir/administration & dosage ; Valganciclovir/adverse effects ; Visual Acuity/drug effects
    • نبذة مختصرة :
      Background: Cytomegalovirus retinitis (CMVR) is an opportunistic infection in HIV-infected people. Intraocular or intravenous ganciclovir was gold standard for treatment; however, oral valganciclovir replaced this in high-income countries. Low- and middle-income countries (LMIC) frequently use intraocular injection of ganciclovir (IOG) alone because of cost.
      Methods: Retrospective review of all HIV-positive patients with CMVR from February 2013 to April 2017 at a Médecins Sans Frontièrs HIV clinic in Myanmar. Treatment was classified as local (IOG) or systemic (valganciclovir, or valganciclovir and IOG). The primary outcome was change in visual acuity (VA) post-treatment. Mortality was a secondary outcome.
      Results: Fifty-three patients were included. Baseline VA was available for 103 (97%) patient eyes. Active CMVR was present in 72 (68%) eyes. Post-treatment, seven (13%) patients had improvement in VA, 30 (57%) had no change, and three (6%) deteriorated. Among patients receiving systemic therapy, four (12.5%) died, compared with five (24%) receiving local therapy (p = 0.19).
      Conclusions: Our results from the first introduction of valganciclovir for CMVR in LMIC show encouraging effectiveness and safety in patients with advanced HIV. We urge HIV programmes to include valganciclovir as an essential medicine, and to include CMVR screening and treatment in the package of advanced HIV care.
    • References:
      J Acquir Immune Defic Syndr. 2015 Jul 1;69(3):e115-7. (PMID: 25844697)
      Int Ophthalmol Clin. 2006 Spring;46(2):91-110. (PMID: 16770157)
      J Acquir Immune Defic Syndr. 2004 Aug 1;36(4):972-7. (PMID: 15220705)
      Eur J Clin Microbiol Infect Dis. 2004 Jul;23(7):550-9. (PMID: 15232720)
      Int Ophthalmol Clin. 2007 Spring;47(2):155-64. (PMID: 17450015)
      J Med Assoc Thai. 2005 Nov;88 Suppl 9:S15-20. (PMID: 16681046)
      Bull World Health Organ. 2014 Dec 1;92(12):903-8. (PMID: 25552774)
      Clin Infect Dis. 2018 Mar 5;66(6):893-903. (PMID: 29373672)
      Clin Infect Dis. 2013 Jul;57(1):147-55. (PMID: 23511301)
      Ophthalmology. 2005 May;112(5):771-9. (PMID: 15878056)
      J Acquir Immune Defic Syndr. 2015 Feb 1;68(2):140-6. (PMID: 25590268)
      Clin Ophthalmol. 2010 Apr 26;4:285-99. (PMID: 20463796)
      Clin Infect Dis. 2013 Nov;57(9):1351-61. (PMID: 23899681)
      Open Forum Infect Dis. 2019 Jun 14;6(7):ofz280. (PMID: 31304189)
      J Int AIDS Soc. 2011 Aug 15;14:41. (PMID: 21843351)
      Pharmacoeconomics. 2007;25(5):413-28. (PMID: 17488139)
      Rev Soc Bras Med Trop. 2019 Jun 27;52:e20180457. (PMID: 31271616)
      PLoS Med. 2007 Dec;4(12):e334. (PMID: 18052600)
      AIDS Rev. 2010 Oct-Dec;12(4):183-94. (PMID: 21179183)
      J Acquir Immune Defic Syndr. 2009 Aug 1;51(4):486-91. (PMID: 19421071)
      Curr Opin Infect Dis. 2000 Dec;13(6):637-641. (PMID: 11964834)
      PLoS One. 2018 Feb 8;13(2):e0191695. (PMID: 29420652)
      Bull World Health Organ. 2001;79(3):208-13. (PMID: 11285664)
    • Contributed Indexing:
      Keywords: Comorbidity; Cytomegalovirus; HIV/AIDS; Retinitis; South-East Asia; Valganciclovir
    • الرقم المعرف:
      0 (Antiviral Agents)
      GCU97FKN3R (Valganciclovir)
      P9G3CKZ4P5 (Ganciclovir)
    • الموضوع:
      Date Created: 20201114 Date Completed: 20201123 Latest Revision: 20201123
    • الموضوع:
      20240628
    • الرقم المعرف:
      PMC7666479
    • الرقم المعرف:
      10.1186/s12879-020-05579-2
    • الرقم المعرف:
      33187478