A Randomized, Comparative, Placebo-Controlled Trial of the Safety and Efficacy of Oral Ganciclovir for Prophylaxis of Cytomegalovirus (CMV) Retinal and Gastrointestinal Mucosal Disease in HIV-Infected Individuals With Severe Immunosuppression

Inclusion Criteria

Concurrent Medication:

Allowed:

• Antiretroviral therapy.
• Anti-PCP prophylaxis.
• Maintenance or prophylaxis therapy for other opportunistic infections besides CMV.

Patients must have:

• Working diagnosis of HIV infection.
• CD4 count <= 100 cells/mm3.
• Positive CMV serology (IgG) or CMV culture, in the absence of active disease, documented at any time prior to study entry.
• Reasonably good health.
• Life expectancy of at least 6 months.

Exclusion Criteria

Co-existing Condition:

Patients with the following symptoms or conditions are excluded:

• Acute life-threatening illness.
• Active lymphoma.
• Hypersensitivity to acyclovir.
• Lack of willingness or ability, in the opinion of the clinician, to comply with protocol requirements.

Concurrent Medication:

Excluded:

• Vidarabine.
• Amantadine hydrochloride (Symmetrel).
• CMV hyperimmune globulin/intravenous immune globulin.
• Cytarabine.
• Fiacitabine (FIAC) or fialuridine (FIAU).
• Foscarnet.
• Intravenous ganciclovir.
• HPMPC.
• Idoxuridine.
• Intravenous acyclovir.
• Oral acyclovir at > 1 g/day.
• Other drugs with potential anti-CMV activity.

Prior Medication:

Excluded within 60 days prior to study entry:

• Foscarnet.

Excluded within 2 weeks prior to study entry:

• Vidarabine.
• Amantadine hydrochloride (Symmetrel).
• CMV hyperimmune globulin/intravenous immune globulin.
• Cytarabine.
• Fiacitabine (FIAC) or fialuridine (FIAU).
• Ganciclovir.
• HPMPC.
• Idoxuridine.
• Intravenous acyclovir.
• Oral acyclovir at > 1 g/day.
• Other drugs with potential anti-CMV activity.

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety