Journal article
A Randomized, Double-Blind Trial of Valaciclovir Prophylaxis for Cytomegalovirus Disease in Patients with Advanced Human Immunodeficiency Virus Infection
The Journal of infectious diseases, Vol.177(1), pp.48-56
01/1998
DOI: 10.1086/513804
Abstract
Cytomegalovirus (CMV) disease is a common complication of advanced human immunodeficiency virus (HIV) infection. Administration of oral valaciclovir, a valine ester of acyclovir, achieves sufficient plasma acyclovir levels to inhibit many clinical isolates. Acyclovir has been associated with enhanced survival in AIDS but not with CMV disease prevention. CMV-seropositive patients (1227) with CD4 cell counts <100/mm3 were enrolled in a randomized, double-blind trial. Valaciclovir, 8 g/day, was compared with acyclovir, 3.2 or 0.8 g/day, for CMV prevention; all three arms were compared for survival. The confirmed CMV disease rate was 11.7% among valaciclovir recipients and 17.5% in the pooled acyclovir arms, a 33% reduction in risk. Time to confirmed CMV disease was significantly longer for the valaciclovir group (P = .03). A trend toward earlier mortality for valaciclovir recipients was seen (P = .06). Toxicity and earlier medication discontinuation were more common in this group. Valaciclovir significantly reduces the risk of CMV disease. Further exploration of a better-tolerated dose is warranted.
Details
- Title: Subtitle
- A Randomized, Double-Blind Trial of Valaciclovir Prophylaxis for Cytomegalovirus Disease in Patients with Advanced Human Immunodeficiency Virus Infection
- Creators
- Judith E Feinberg - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomShelley Hurwitz - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomDavid Cooper - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomFred R Sattler - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomRob Roy MacGregor - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomWilliam Powderly - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomGary N Holland - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomPaul D Griffiths - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomRichard B Pollard - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomMichael Youle - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomM. John Gill - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomFiona J Holland - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomMaureen E Power - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomSusan Owens - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomDion Coakley - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomJohn Fry - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomMark A Jacobson - Department of Medicine, University of Cincinnati, Cincinnati, Ohio, Boston, Massachusetts, Sydney, Australia, Los Angeles, Los Angeles, San Francisco, California, Philadelphia, St. Louis, Missouri, London, United Kingdom, Galveston, Calgary, Canada, Bethesda, Maryland, Research Triangle Park, Maryland, and Beckenham, United KingdomAIDS Clinical Trials Group Protocol 204/Glaxo Wellcome 123‐014 International CMV Prophylaxis Study Group
- Contributors
- J T Stapleton (Contributor) - University of Iowa, Internal Medicine
- Resource Type
- Journal article
- Publication Details
- The Journal of infectious diseases, Vol.177(1), pp.48-56
- Publisher
- The University of Chicago Press
- DOI
- 10.1086/513804
- ISSN
- 0022-1899
- eISSN
- 1537-6613
- Language
- English
- Date published
- 01/1998
- Academic Unit
- Microbiology and Immunology; Infectious Diseases; Internal Medicine
- Record Identifier
- 9984094588402771
Metrics
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