An overview of current and future treatment options for patients with cytomegalovirus retinitis

Abstract

Introduction: Cytomegalovirus (CMV) retinitis is an important cause of morbidity in patients with HIV/AIDS and iatrogenic or local (ocular) immunosuppression. No new drugs have been approved for the treatment of CMV retinitis since 2001, and several have been taken off the market. This paper reviews currently available anti-CMV drugs, their side effects, and investigational drugs that may be useful in patients with intolerance or resistance to approved therapy.

Areas covered: In this review, the epidemiology, clinical features, and treatment of CMV retinitis is summarized. Limitations of current therapy as a result of drug toxicity and resistance are reviewed, with an emphasis on the lack of new drug development in this field. The limitations of current anti-CMV therapy in patients who are iatrogenically immunosuppressed are highlighted. Investigational drugs with potential to treat CMV retinitis are discussed.

Expert opinion: Currently therapy for the treatment of CMV retinitis is limited by drug toxicity, antiviral resistance, and a failure to develop new drugs with more favorable side effect profile and a different mechanism of activity. The marked reduction in the incidence of CMV retinitis is patients with AIDS in the era of combination antiretroviral therapy (ART) has resulted in the removal of several FDA-approved drugs by manufacturers due to poor sales and created a disincentive for new drug development.

Keywords::

• AIDS
• cidofovir
• congenital
• cytomegalovirus retinitis
• epidemiology
• foscarnet
• ganciclovir
• ganciclovir
• immunosuppression
• treatment

Notes

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