A viral infection that robs AIDS patients of their sight can now be fought with a drug in pill form, allowing patients a better quality of life, say the authors of a recent paper in The New England Journal of Medicine.
Prior to this research, physicians treated the infection cytomegalovirus (CMV) retinitis with a drug called ganciclovir, which was only available intravenously. "Patients had permanent catheters - akin to intravenous lines - inserted into the large veins in the chest," says Dr. Sharon Walmsley of the University of Toronto's medicine department and a senior scientist at the University Health Network (Toronto General Hospital). "They had to self-administer the drug (or with the help of a nurse or other person) once or twice a day for the rest of their lives. It was very inconvenient, made working or travel difficult and patients were prone to infections of the lines resulting in blood infection. Also, patient privacy was compromised as anyone who saw the line immediately knew they were ill."
In clinical trials with 160 AIDS patients, the international team of researchers found the pills, called valganciclovir, to be as effective as the traditional intravenous treatment.
CMV retinitis is the leading cause of blindness among patients in the late stages of AIDS. While the infection originates from a germ or virus to which most people have been exposed, it lies dormant in the general population. However, if a person's immune system is damaged - as in the case of HIV or transplant patients - the virus can reactivate. The incidence of blindness caused by CMV retinitis has dropped considerably, largely due to better HIV treatments. Other investigators are now examining whether the pills are as effective in transplant patients. The research was funded by Roche Pharmaceuticals.
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