How to Treat Cytomegalovirus?


Medical Treatment:
Ganciclovir
Ganciclovir is the treatment of choice, but it is toxic and costly and can only be used by a well- known specialist. Patients on ART begin as soon as possible after initiation of ganciclovir to prevent recurrent disease.
Consider the initial systemic ganciclovir therapy for all patients, but intraocular therapy is a limited retinitis option.
Intravitreal ganciclovir, 2 mg once a week.
  • Once immune function has been restored with antiretroviral therapy( CD4 > 100 cells / mm3) and active retinitis characteristics have been cleared, ganciclovir maintenance may be stopped, but recurrence monitoring may be performed.
Maintenance therapy can only be used for CNS and retinitis. During therapy, regularly monitor FBC. Avoid other drugs related to the SUPPRESSIONof bone marrow, especially zidovudine.
GIT and other organ diseases
* Ganciclovir, IV, 5 mg / kg 12 hours for 14 days. Initiated specialist. Maintenance treatment shall not be indicated unless a relapse occurs.
CNS
Treatment initial:
  • Ganciclovir, IV, 5 mg / kg 12 hours 14 days. Initiated specialist.
Maintenance treatment:
Maintenance should only be considered for patients with a good clinical response, since the costs are currently very high.
  • Ganciclovir, IV, 5 mg / kg per day up to > 100 cells / mm3 of CD4 count on ART.

When to refer:
Specialist or tertiary

  • All patients.

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