Complications

Complication
Timeframe
Likelihood
short term
high

The most common side effect of intravenous ganciclovir or valganciclovir therapy is bone marrow suppression, most commonly with leukopenia and thrombocytopenia.[81] Reducing ganciclovir dose has been used to manage this complication, although this may lead to resistant virus. Use of granulocyte colony-stimulating factor (G-CSF) has been suggested as potential treatment.[82]

short term
high

The most dreaded complication of cidofovir and foscarnet therapy is renal failure.[1]​ This can be managed by adequate fluid infusions. Probenecid is given concomitantly with cidofovir to prevent renal toxicity.[2]​​

short term
high

Disturbance in electrolytes, particularly calcium, magnesium, and phosphorus, is common during treatment with foscarnet.[2]​ Routine monitoring for these derangements and supplementation of deficient electrolytes is recommended.

short term
low

When the immune system recovers, as a result of antiretroviral therapy in the treatment of AIDS, there may be a paradoxical worsening of cytomegalovirus-induced inflammation in the eye.[55] This has been treated by some specialists with corticosteroids.[2]​​

variable
high

Congenital cytomegalovirus (CMV) infection is the leading cause of sensorineural deafness, intellectual disability, and visual impairment.[10]​ Neurologic sequelae include spasticity, hemiparesis, seizures, and developmental delay.[48][49]

variable
medium

Invasion of cytomegalovirus (CMV) in the retina causes permanent damage, so that even if the viral infection is controlled, the destruction of the retina is not reversible. Hence, early diagnosis of CMV retinitis is key to the prevention of permanent blindness.[38]​​

Evaluation of vision loss

variable
medium

Cytomegalovirus (CMV) disease is associated with increased risk of other opportunistic infections. In the long term, it has been associated with acute and chronic allograft rejection and increased overall mortality.[79][80]

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