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Executive Summary

ACYCLOVER ANALOG DHPG CLINICALS FOR TREATMENT OF CYTOMEGALOVIRUS disease in patients with Acquired Immune Deficiency Syndrome (AIDS) are being conducted at the Natl. Institutes of Health. NIH Dept. of Critical Care Medicine Deputy Director Henry Masur, MD, told the Natl. Advisory Allergy and Infectious Disease Council May 20 that NIH has results from testing eight AIDS patients with cytomegalovirus (CMV) who were treated with the compound. He reported that the extent of improvement with DHPG treatment is "really quite dramatic." Of seven AIDS patients with vision-threatening retinitis caused by CMV, one had a complete response to therapy with DHPG, and five had partial responses. Only one patient had no response, Masur said. "If you look at individual eyes, four of 13 eyes had complete responses, seven of 13 eyes had a partial response, so a total of 11 of the 13 eyes had what we would consider a very good response." Another patient who responded favorably to therapy was suffering from what Masur characterized as life-threatening colitis, with an approximate 90 pound weight loss due to an average 25 diarrhea stools per day. Following treatment with the acyclovir analog, the patient's diarrhea was reduced to four stools a day, and the patient began to gain weight, Masur reported. He noted, however, that infections appear to recur when drug therapy is stopped. "We think DHPG is really a major advance in therapy of cytomegalovirus disease and we are continuing our studies looking at the efficacy of this in a variety of clinical situations," he said. Masur emphasized the "significant amount of morbidity and mortality in the AIDS population" caused by CMV infections. "The disease that more and more of these patients are ultimately dying from is disseminated cytomegalovirus," he said. "And in the past, there was no drug that was effective in any population for CMV." Results of another NIH trial involving four AIDS patients treated with suramin were presented by Natl. Institute of Allergy and Infectious Diseases Deputy Clinical Director Clifford Lane. While no clinical responses were reported, Lane noted that investigators were unable to recover HTLV-III virus from the patients' blood following several weeks of suramin administration. He said that when the drug is discontinued, however, the virus can once again be isolated from peripheral blood. "We feel that suramin, when given systemically, does have the ability to inhibit replication of the AIDS retrovirus, at least inhibit our ability to recover it from their peripheral blood," he said. "Using viral chemotherapy to directly inhibit the replication of the AIDS retrovirus may be the important missing link in attempting to permanently prevent the progressive immunologic defect which these patients exhibit."

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