IDSA Recommendations for Treating Cytomegalovirus Infections in HIV-AIDS Preventing CMV Disease: • CMV end-organ disease is best prevented by using ART to maintain CD4 count >100 cells/mm3 Managing CMV Retinitis: • The choice of initial therapy for CMV retinitis should be individualized, based on location and severity of the lesion(s), the level of immunosuppression, and other factors (e.g., concomitant medications, ability to adhere to treatment). • Given the evident benefits of systemic therapy in preventing contralateral eye involvement, reduce CMV visceral disease and improve survival,whenever feasible, treatment should include systemic therapy. • The ganciclovir ocular implant, which is effective for treatment of CMV retinitis, is no longer available. Initial Therapy Followed by Chronic Maintenance Therapy—For Immediate Sight Threatening Lesions (within 1500 microns of the fovea) - Preferred Therapy: • Intravitreal injections of ganciclovir (2 mg/injection) or foscarnet (2.4 mg/injection) for 1–4 doses over a period of 7–10 days to provide higher intraocular levels of drug and faster control of the infection until steady state intraocular ganciclovir concentrations are achieved; plus • Valganciclovir 900 mg PO BID for 14–21 days, then 900 mg once daily #Cytomegalovirus #CMV #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
