Related Experiment Videos
Sensitivity of cytomegalovirus to intravenous foscarnet treatment
A Akesson-Johansson1, J O Lernestedt, O Ringdén
1Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.
Abstract:
Intravenous foscarnet was given on an emergency basis to 30 immunosuppressed patients with cytomegalovirus (CMV) disease, of whom 28 were organ transplant recipients. Thirteen patients responded to foscarnet by cessation of CMV secretion. The in vitro sensitivity to foscarnet of the CMV isolates from non-responders before, during and after foscarnet treatment was similar to that of viral isolates from responders before or during foscarnet treatment and also to CMV isolates from non-treated patients, with mean in vitro IC50 values of 239-294 microM of foscarnet. Thus, there was no evidence of increased resistance of the CMV isolates obtained after foscarnet treatment. A higher total foscarnet dose appeared to favor response.
Insights
Foscarnet treatment for cytomegalovirus (CMV) disease in immunosuppressed patients showed that higher doses may improve response. CMV isolates did not develop increased resistance to foscarnet during treatment.
Area of Science:
- Virology
- Immunology
- Pharmacology
Background:
- Cytomegalovirus (CMV) poses a significant threat to immunosuppressed individuals, particularly organ transplant recipients.
- Effective antiviral therapies are crucial for managing CMV disease in vulnerable populations.
Purpose of the Study:
- To evaluate the efficacy of intravenous foscarnet in treating cytomegalovirus (CMV) disease in immunosuppressed patients.
- To investigate the development of foscarnet resistance in CMV isolates during treatment.
Main Methods:
- Retrospective analysis of 30 immunosuppressed patients receiving emergency intravenous foscarnet for CMV disease.
- Assessment of patient response based on cessation of CMV secretion.
- In vitro testing of CMV isolate sensitivity to foscarnet (IC50 values) before, during, and after treatment.
Main Results:
- Thirteen of 30 patients (43%) responded to foscarnet, indicated by the cessation of CMV secretion.
- In vitro sensitivity analyses showed no increased resistance of CMV isolates to foscarnet in non-responders compared to responders or untreated patients.
- A trend suggested that a higher total foscarnet dose might be associated with a favorable treatment response.
Conclusions:
- Intravenous foscarnet can be effective in managing CMV disease in select immunosuppressed patients.
- Current treatment regimens with foscarnet do not appear to induce significant in vitro resistance in CMV isolates.
- Further investigation into optimal dosing strategies for foscarnet is warranted to maximize treatment efficacy.