Clinical Experience With Cidofovir in the Treatment of Cytomegalovirus Retinitis

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Abstract
Cidofovir (Vistide, HPMPC) is a nucleotide analogue with potent in vitro activity against cytomegalovirus (CMV) that was recently licensed for treatment of patients with acquired immunodeficiency syndrome (AIDS) and CMV retinitis. Cidofovir's prolonged intracellular half-life permits dosing once every 2 weeks for maintenance treatment. The treatment-limiting toxicity of cidofovir is dose- and schedule-dependent nephrotoxicity affecting renal proximal convoluted tubule cells. A treatment regimen that includes concomitant administration of oral probenecid, intravenous hydration, and careful preinfusion evaluation of renal function with conservative dose modification has reduced cidofovir-associated nephrotoxicity. Preliminary results of clinical studies of cidofovir in AIDS patients with newly diagnosed and relapsing CMV retinitis are described.

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