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INCIDENCE OF CMV RETINITIS (CMVR)

• Pre-HAART
• 30 of patients with CD4 lt50 (Kuppermann et al,
  AJO 1993 Spector et al, NEJM 1996)
• Post-HAART
• 75 decline in CMV disease (Doan et al, AJO
  1999)

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CONTINUED NEED FOR CMV THERAPY

• New cases of CMVR still occur
• Incidence may increase as patients fail
  anti-retroviral therapy
• For patients on HAART, development of CMVR
  represents failure of therapy
• New CMVR requires anti-CMV therapy

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CURRENT CMVR TREATMENT OPTIONS
IV GCV
IV GCV
Oral GCV
GCV Implant Oral GCV
IV Foscarnet
IV Cidofovir
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CURRENT CMVR TREATMENT OPTIONS
Indwelling catheter, QOL, sepsis (1.3
events/pt-yr)
IV GCV
IV GCV
Limited bioavailability, TID dosing, 6-12 caps
daily
Oral GCV
GCV Implant Oral GCV
Surgical procedure
IV Foscarnet
Catheter, long infusion time, sepsis, QOL, renal
toxicity
IV Cidofovir
Renal ocular toxicity, 50 probenecid allergy
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GOALS FOR NEW TREATMENT DEVELOPMENT

• Oral agent effective for both induction and
  maintenance treatment
• No IV catheter requirement
• Convenient dosing regimen
• Acceptable safety profile

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