What is the role of valganciclovir in the treatment of cytomegalovirus (CMV) encephalitis in HIV?

Updated: Jul 25, 2017
  • Author: Gulshan Uppal, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Oral valganciclovir has very good bioavailability and can be used for long-term prophylaxis. Patients not responding to ganciclovir should be evaluated for ganciclovir resistance, a common cause of treatment failure. Most of these patients remain sensitive to foscarnet.

The goal of pharmacotherapy is to shorten the clinical course and prevent or decrease complications, latency, recurrences, transmission, and established latency. Highly active antiretroviral therapy (HAART) is effective in reconstituting the immune system and preventing CMV reactivation. [5] Current guidelines recommend discontinuation of secondary prophylaxis in HAART recipients with a sustained (>6 mo) increase in CD4+ T cells to greater than 100-150 cells/µL. [3]


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