HIV in Children

TREATMENT FOR CYTOMEGALOVIRUS INFECTION (CMV)

Dr. Ira Shah
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Last Updated : 1st September 2012

Drugs

Dosage

Adverse Effects

Remarks

Ganciclovir Induction phase
5 mg/kg every 12 hours IV for 14-21 days [in disseminated disease & CMV retinitis]

6 mg/kg every 12 hours IV for 6 weeks [in symptomatic congenital infection]

Prophylaxis
30 mg/kg tid PO
OR 5 mg/kg/day IV x 5 days/week
Neutropenia, Myelosuppression, Renal toxicity, CNS effects, GI dysfunction, thrombophlebitis and elevated liver enzymes Combination therapy with Ganciclovir & Foscarnet can be used in children with sight threatening disease.
Foscarnet 60 mg/kg tid IV for 14-21 days, then 90-120 mg/kg once a day for chronic suppression. Renal dysfunction, Electrolyte imbalance (especially in calcium, phosphorus, magnesium and potassium levels), seizures, cardiac arrhythmia's, elevated liver enzymes and CNS symptoms Used in induction phase as alternative in case of ganciclovir resistant CMV
Valganciclovir 500mg/m2/day PO in 2 divided doses followed by 250 mg/m2/day OD as maintenance Myelosuppression May be used in adolescents. Data in children is lacking.

TREATMENT FOR CYTOMEGALOVIRUS INFECTION (CMV)
Dr. Ira Shah
Incharge Pediatric HIV and TB Clinic, B.J.Wadia Hospital for Children, Mumbai, India Consultant in Pediatric Infectious Diseases, Nanavati Hospital, Mumbai, India.