Progressive Disease Due to Ganciclovir-Resistant Cytomegalovirus in Immunocompromised Patients

CYTOMEGALOVIRUS (CMV) infections are a major cause of morbidity and mortality among immunocompromised patients, especially recipients of bone marrow and solid-organ transplants and those with the acquired immunodeficiency syndrome (AIDS).^{1 2 3 4} More than 90 percent of patients with AIDS are infected with CMV,⁴ and there is evidence of disseminated CMV at autopsy in 93 percent of this patient population.⁵ Ganciclovir (9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine) has been studied in preliminary clinical trials for the treatment of severe CMV disease in immunocompromised patients.^{6 7 8 9 10 11 12 13 14 15 16 17} Although all studies have been uncontrolled, ganciclovir appears to be beneficial in CMV retinitis and in CMV involvement of the gastrointestinal….