Treatment of Cytomegalovirus Disease

To the Editor: Glatt and colleagues correctly note the limitations of ganciclovir (dihydroxypropoxymethyl guanine) in the treatment of cytomegalovirus pneumonia (June 2 issue).¹ Nonetheless, they conclude, probably prematurely, that this drug produces clinical benefit in cytomegalovirus-induced retinitis and gastrointestinal disease, conditions in which assessment of the efficacy of antiviral chemotherapy is particularly difficult.² Indeed, the role of ganciclovir in the treatment of cytomegalovirus disease remains unproved.² Early specific diagnosis of cytomegalovirus infection may be important in evaluating the clinical efficacy of ganciclovir.² However, the basis for diagnosis recommended by Glatt and colleagues — histopathological evidence of cytomegalovirus infection¹ — cannot.