Since CMV is recognized as one of the leading opportunistic infections in AIDS patients, it is important to monitor blood, urine, and tissue specimens from patients enrolled in various clinical trials for the presence of CMV infections. We are currently following patients who are on combination therapies against HIV-1: AZT/IL2, IFN alpha/IL2, and a combination of AZT, IFN, AZT/IFN (three arms trials). Additionally, we are following a small group of identical twins (only one is HIV-1 infected) who have undergone autologous bone marrow transplantation for CMV infections. Another goal of this project is to determine if CMV can be isolated from bronchial lavage specimens taken from both asymptomatic as well as symptomatic (WR 1-2) HIV-1 patients. It may provide an early indicator of reactivated CMV in these patients and lead to initiation of early treatment to prevent systemic fulminating disease. Foscarnet (trisodium phosponoformate) an antiviral agent with invitro activity against both herpesviruses (including CMV) and HIV-1 was shown to have in vivo activity in AIDS patients with CMV retinitis. Improvement was documented by a reduction in isolation of CMV in culture specimens, improved vision and reduced HIV-1 p24 antigen levels.
