AIDS Treatment News Issue #227, July 21, 1995
One part of the case for AIDS research funding is that this
research advances our understanding of the immune system,
which is critically important in many other diseases,
including cancer and many autoimmune conditions. But it can
be hard to identify concrete benefits, because it takes time
for the new knowledge to be applied in other diseases --
especially so for results from basic research, which can
ultimately be most important.
One clear example of an AIDS research "spin-off" helping in
the treatment of other conditions is the use of ganciclovir
for preventing CMV infection in transplant patients -- who
are vulnerable to infections because of the immune-
suppressive drugs they must take. A recent study tested
ganciclovir in 250 liver-transplant patients.(1) Despite
conventional preventive treatment with high-dose acyclovir,
CMV infection occurs in 10 to 50 percent of these patients.
When CMV disease develops, it can cause death; and
hospitalization costs are estimated at $10,000 to $50,000 per
Ganciclovir prophylaxis for 100 days after surgery greatly
reduced CMV infection (to 5%, vs. 38% with acyclovir) and
symptomatic CMV disease (to less than 1%, from 10% with
acyclovir; the only patient who got CMV disease while taking
ganciclovir had received a liver from a donor with CMV
hepatitis). Side effects were minimal. Intravenous
ganciclovir was used in this research, but oral ganciclovir,
now being tested in other studies, may also prove effective.
Ganciclovir would probably never have been developed if it
had not been needed for AIDS. Now it has proven benefit in
liver transplantation, and probably equal benefit in other
organ transplantation as well.
1. Winston DJ, Wirin D, Shaked A, and Busuttil RW.
Randomized comparison of ganciclovir and high-dose acyclovir
for long- term cytomegalovirus prophylaxis in
liver-transplant recipients. The Lancet. July 8, 1995; volume
346, page 69.