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. The following clinical protocols are currently in progress: (1) Combination therapies against HIV-1 : AZT/IL2, IFN-alpha /IL2, and a three arm trial of combination AZT, IFN, and AZT/IFN. In addition, we are following a small group of identical twins (only one is HIV-1 infected) who have undergone autologous bone marrow transplantation. (2) Another goal of this project is to determine if CMV can be isolated from bronchial lavage specimens taken from asymptomatic as well as symptomatic HIV-1 patients. It may provide an early indicator of reactivated CMV in these patients, and lead to early initiation of anti- CMV treatment to prevent systemic fulminating disease. (3) Clinical trial with the drug foscarnet (trisodium phosphonoformate) for the treatment of HIV-1 patients with CMV retinitis. Improvement was documented by a reduction of CMV isolation from tissue specimens, improved vision, and reduced HIV-1 p24 levels. (4) A randomized, double blind, controlled trial to determine the efficacy of CMV-immuneglobulins for prophylaxis of CMV infections in AIDS patients.
