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Predisposition to Cytomegalovirus Infection of the Gastrointestinal Tract
- Michael A. Poles, MD;
- Edward A. Lew, MD; and
- Douglas T. Dieterich, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
Goodgame's interesting review of cytomegalovirus gastrointestinal disease [1] overlooked several studies of its treatment in patients with the acquired immunodeficiency syndrome (AIDS). In a placebo-controlled study, ganciclovir resulted in greater treatment success for cytomegalovirus colitis (63% compared with 37%), improved endoscopic scores, and decreased dissemination of cytomegalovirus disease [2]. Foscarnet was shown to induce remission in 67% of patients who were unresponsive to ganciclovir [3]. The concurrent use of these drugs may lead to response in 90% of patients who fail both drugs when they are used alone [4].
The mortality rate for untreated cytomegalovirus gastrointestinal disease is high. Switching to foscarnet after failure of ganciclovir therapy prolongs life a median of 5 additional months [3], whereas combination therapy after failure of both agents when they are used alone may increase survival by an additional 6 to 7 months [4].
Foscarnet used in a twice-daily dosing schedule (90 mg/kg) decreases adverse effects [5], which allows home administration and thus decreased hospital costs.
Michael A. Poles, MD
Edward A. Lew, MD
Douglas T. Dieterich, MD
New York University Medical Center; New York, NY 10016
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
