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AIDS Treatment Data Network
(ATDN) Cidofovir (HPMPC)

August 1, 1995
Treatment Review; August 1995

The drug cidofovir, also known as HPMPC, is now in clinical trials. In earlier studies, this drug caused kidney damage (renal toxicity). It also demonstrated strong activity against CMV, for an extended period of time. When the effect of the first infusion wears off - in about 7 days - the second infusion appears to have the same effect, and last the same amount of time. At this point it is not known whether the drug actually ever stops working against CMV. Both foscarnet and ganciclovir eventually stop working, and CMV progresses after about 6 months.

The first studies of cidofovir indicate that the best way to give the drug is once a week. The new study that is described below will give the drug once a week for the first two weeks, then once every two weeks. If this turns out to be an effective way to give this drug, it would certainly be more convenient and less invasive than the usual once or twice a day infusions of the already approved drugs.

To participate in this trial you must have failed previous treatment. Requirements for failing previous treatment vary according to the location of the CMV infection in your eye. All participants are treated with cidofovir. After the two week induction period, participants are randomized to 2 different doses. Treatment is once a week for 2 weeks and once every other week after that. Clinic visits may require two days of visits, all outpatient. All participants receive probenicid and saline hydration at the same time. Probenicid helps protect the liver from possible side effects due to treatment with cidofovir. Probenicid is a pill. Cidofovir is given by intravenous infusion.

To participate, you must be 18 years or older with CMV retinitis that has progressed while on foscarnet or ganciclovir for at least a 4 week period. You may not have been treated with ganciclovir or foscarnet within 2 days of starting the study. You may not have ever been treated with cidofovir. You must do a one week washout from anti-CMV investigational agents. If you have an intravitrial implant with ganciclovir, the implant will have to be taken out before starting the study. For more information about this study, or the treatment or prevention of CMV, call The Network at (800) 734-7104.

Although there is no guarantee that the drug cidofovir will not cause side effects, researchers and some people with AIDS support the continued testing of this drug because it holds great promise. By adding the drug probenicid to the study, researchers hope that the kidneys will not be damaged. This drug has been used for this purpose with other drugs.