Antiviral Effects of Foscarnet and Ganciclovir Therapy on Human Immunodeficiency Virus p24 Antigen in Patients with AIDS and Cytomegalovirus Retinitis

• Published in: The Journal of infectious diseases Vol. 172; no. 3; pp. 613 - 621
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.09.1995; University of Chicago Press
• Subjects: AIDS; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antigens; Antiretrovirals; Antiviral agents; Antivirals; Biological and medical sciences; Cytomegalovirus; Cytomegalovirus retinitis; HIV; human immunodeficiency virus; International Statistical Classification of Diseases; Major Articles; Medical sciences; Mortality; Pharmacology. Drug treatments; Retinitis; Human; Immunopathology; Cytomegalovirus; Retinopathy; Prognosis; Herpesviridae; Treatment efficiency; AIDS; Betaherpesvirinae; Immune deficiency; Survival; Infection; Virus; Eye disease; Chemotherapy; Treatment; Viral disease; Retinitis; Comparative study
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/172.3.613

To examine whether the prolonged survival seen in patients treated with foscarnet compared with those treated with ganciclovir was due to a direct effect on human immunodeficiency virus (HIV) replication, HIV p24 antigen was measured. Of 71 receiving foscarnet, 54% were p24 antigen-positive at enrollment (vs. 44% of 79 receiving ganciclovir). By immune complex-dissociated (ICD) p24 antigen analysis, 87% and 78%, respectively, were positive. After 1 month of treatment, there was a significant decline in standard (mean decline, 10.1 pg/mL) and ICD (mean, 39.6 pg/mL) p24 antigen in both groups (P = .0001). Mortality was greater in those who were ICD p24 antigen-positive than in those —negative at baseline (P = .03) and in subjects with an increase in ICD p24 antigen than in those with a decline (P = .09). Thus, each drug had a suppressive effect on circulating p24 antigen, which was predictive of improved survival. The inhibitory effect on CMV replication may have a beneficial effect on limiting HIV replication.