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Being Alive
MEDICAL UPDATE: Two Studies of CMV Prophylaxis
presented by Mark Katz, MD and reported by Jim Stoecker
November 5, 1993
Being Alive 1993 Nov 5: 13

CMV not only attacks the retina, but can attack the inner organs as well. This infection is found in late stage HIV disease and remains the last major opportunistic infection for which no effective prophylaxis is yet available.

Now we have word on two large studies that are trying to develop that prophylaxis. If we could prevent CMV, we would make great headway in improving the quality of life for PWAs.

The first study uses oral ganciclovir as CMV prophylaxis. As noted above, ganciclovir, given intravenously, is an effective treatment for acute CMV infection. As an IV drug, however, it is not practical as prophylaxis. Now ganciclovir has been reformulated as an oral drug. The question is whether this oral dose will allow enough of the drug into the bloodstream to prevent CMV infection. This is what the study will try to determine.

Over 700 people are involved in this oral ganciclovir study throughout the US. To participate, you must have CD4 under 50 or under 100 if an opportunistic infection has already occurred, and no active CMV. For information on the local sites of this study, call Dr. Bernard MacNamara at Kraus-Beer Medical Group (213.957.7840) or Dr. Gail Simpson at Harbor/UCLA (310.222.2365).

The second study is using BW256U87, an acyclovir prodrug. When this drug is in the body, it is rapidly absorbed and changed to acyclovir. As you may know, acyclovir is an anti-herpes drug and herpes is in the same viral family as CMV. The theory is that the prodrug may make a high enough level of acyclovir available to actually prevent CMV. The study (ACTG 204) has recently reopened for recruitment. See details below.