SURVIVAL OF PATIENTS WITH AIDS AND CYTOMEGALOVIRUS DISEASE TREATED WITH GANCICLOVIR OR FOSCARNET

We reviewed the hospital charts of 168 patients with AIDS and cytomegalovirus (CMV) disease diagnosed at San Francisco General Hospital between July 1985 and October 1989. One hundred and thirty-three patients had CMV retinitis, 33 had CMV gastrointestinal disease, and two had CMV lung disease. We found a trend towards longer survival from time of CMV disease diagnosis in patients with more recent dates of diagnosis. The median survival of patients diagnosed with CMV disease prior to 30 September 1987 was 4 months, compared with 9 months for patients diagnosed after 30 September 1987 (P = 0.001). The relative hazard of death for patients with CMV retinitis who were initially treated with foscarnet was not significantly reduced compared to those initially treated with ganciclovir. Even after controlling for age at time of CMV diagnosis, time from index AIDS diagnosis, hemoglobin, absolute lymphocyte count, absolute neutrophil count and concurrent zidovudine therapy, the relative hazard for foscarnet-treated patients compared with ganciclovir-treated patients was 1.0 (95% confidence interval, 0.5-1.8).