A trial of vidarabine for cytomegalovirus infection in renal transplant patients

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Abstract
Vidarabine was evaluated in renal transplant patients as a potential therapeutic agent in cytomegalovirus (CMV) infection. Four patients received vidarabine on an open protocol, then 10 additional patients were enrolled in a double-blind protocol. Among the 9 patients who received vidarabine, no notable clinical improvement occurred in the vidarabine- or placebo-treated groups. Vidarabine showed no therapeutic effect in the treatment of CMV infections at the dosages used. Four patients showed dramatic CNS deterioration within several days of the onset of vidarabine therapy. Tremors and myoclonus were common and 1 patient had unusual brain pathologic changes with widespread neuronal chromatolysis. The pathologic findings in the brain in the other 3 patients were complex and included intracerebral hemorrhage, Fabry''s disease, coccidioidomycosis meningitis and cerebral vascular occlusion. There was no conclusive proof that vidarabine contributed to the sudden neurologic deterioration of these patients.

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