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Ganciclovir Therapy for Congenital Cytomegalovirus Infection in Six Infants

Tanaka-Kitajima, Naoko MD*; Sugaya, Naomi MD†; Futatani, Takeshi MD∥; Kanegane, Hirokazu MD∥; Suzuki, Chizuko MD‡; Oshiro, Makoto MD§; Hayakawa, Masahiro MD§; Futamura, Masahide MD¶; Morishima, Tsuneo MD#; Kimura, Hiroshi MD†

Pediatric Infectious Disease Journal: September 2005 - Volume 24 - Issue 9 - pp 782-785
doi: 10.1097/01.inf.0000177280.28694.00
Original Studies

Background: Congenital cytomegalovirus (CMV) infection is common, and its morbidity rate is high. Ganciclovir (GCV) treatment has been used for congenital CMV infection, but there are few reports on viral loads associated with GCV therapy.

Methods: A real-time PCR assay was used to monitor viral load in 6 cases of symptomatic CMV infection that received GCV therapy. Initially GCV was given at a dose of 5–12 mg/kg/d for 2–7 weeks. In 2 cases, additional doses were given as symptoms returned.

Results: After GCV administration, active signs of chorioretinitis, thrombocytopenia and anemia disappeared or improved in all cases. During GCV therapy, viral loads decreased while patients improved clinically and increased again when GCV therapy was stopped. Although CMV DNA continued to be detectable for a long period, clinical findings did not always worsen. In 2 cases, an improvement of hearing loss was observed.

Conclusion: GCV therapy transiently suppresses the CMV concentrations. Subsequent increases of viral titers do not appear to be correlated with the clinical course or neurologic outcome.

From the *Department of Pediatrics, Nagoya Memorial Hospital, †Department of Pediatrics, Nagoya University Graduate School of Medicine, ‡Department of Pediatrics, the Japanese Red Cross Nagoya First Hospital, and §Maternity and Prenatal Care Center, Nagoya University Hospital, Nagoya; ∥Department of Pediatrics, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Toyama; ¶Department of Neonatology, Aichi Prefectural Colony, Central Hospital, Aichi; and #Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan

Accepted for publication April 7, 2005.

See also the supplementary figure published online.

Address for reprints: Hiroshi Kimura, MD, PhD, Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. Fax 81-52-744-2974; E-mail hkimura@med.nagoya-u.ac.jp.

© 2005 Lippincott Williams & Wilkins, Inc.