REPLY
Acyclovir and Ganciclovir in Cytomegalovirus
Nina Singh, MD, and
Victor L. Yu, MD
1 September 1994 | Volume 121 Issue 5 | Page 385
IN RESPONSE:
Dr. Moss appears to have misinterpreted the study design [1]. Only the experimental group, not the acyclovir group, received short-course ganciclovir as prophylaxis for CMV infection (shedding). Thus, the study compared acyclovir with no prophylaxis in the treatment of CMV infection (shedding) and compared acyclovir with preemptive short-course (7 days) ganciclovir prophylaxis in treating CMV disease. The incidence of CMV infection did not differ between patients receiving acyclovir and those receiving no prophylaxis. Cytomegalovirus disease, however, occurred significantly less frequently in the group receiving preemptive ganciclovir prophylaxis for CMV shedding. Any patient (in either group) developing CMV disease (the ultimate study end point) was treated with ganciclovir for 14 to 21 days, the accepted therapy of choice.
1. Singh N, Yu VL, Mieles L, Wagener MM, Miner RC, Gayowski T. High-dose acyclovir compared with short-course preemptive ganciclovir therapy to prevent cytomegalorvirus disease in liver transplant recipients. A randomized trial. Ann Intern Med. 1994; 120:375-81.
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