Ganciclovir Treatment for Cytomegalovirus Infection in Immunocompromised Patients With Renal Disease

The safety and efficacy of a 10-day course of ganciclovir therapywas assessed in 17 consecutive patients with proven cytomegalovirusinfection. The patients were receiving immunosuppressive therapyfor a variety of non-malignant renal conditions, including renaltransplantation (seven patients), small vessel vasculitis (sixpatients), systemic lupus erythematosus (three patients) andGoodpasture's disease (one patient). Fifteen patients were pyrexialat the time of their cytomegalovirus infection. Twelve patientshad pneumonitis manifesting as a pulmonary parenchymal infiltrateor a reduction in gas transfer. Fourteen patients had a significantlymphopenia (lymphocyte count <1x10⁹/l), nine were leucopenic(white cell count <3.5xtimes 10⁹/l) and nine had abnormalliver biochemistry. One patient had an infection of the ileumand one an infection of the larynx. All these disease manifestationsresponded completely to a single course of ganciclovir therapy.There were no clinical relapses and no side effects were observed. Ganciclovir is a safe and effective therapy when administeredearly in the course of cytomegalovirus infection in immunosuppressedpatients with renal impairment.