Meta Analysis Of Treating Cytomegalovirus Diseases In Infants With Ganciclovir

ObjectiveTo assess and compare the efficacy of ganciclovir in the treatment for infants with cytomegalovirus diseases.MethodsThe randomized controlled trials (RCTs) and quasi-RCTs on ganciclovir therapy for cytomegalovirus diseases were reviewed in the following electronic databases (The Cochrane library, Pubmed, EMBASE, Medline, CBM, VIP and CNKI) and other sources till January 30.2010 without language restriction.Randomised controlled trials (RCTs) were assessed according to the Jadad assessment.Two reviewers assessed the quality of included studies, extracted data and processed meta analysis of homogenous studies using RevMan 5.0, other studies were reviewed and described.ResultsSixteen papers were included out of 2131 papers.There were 14 articles in grade I b,2 in grade II a.We assessed the efficacy of ganciclovir combined with supported therapy (438 cases) VS supported therapy alone (415cases) by analyzing 16 controled trials.There were significant differences in total effective rate (RR=1.95,95%CI:1.58-2.41) and urine CMV-DNA negative conversion ratio (RR=0.34,95%CI:0.25-0.45).Meta analysis showed that the ganciclovir therapy decreased incidence of hearing impairment (4.7% vs 37.2%; P<0.01) as compared with the non-ganciclovir therapy controlled group.One RCT study suggests that infants with symptomatic congenital CMV involving the CNS receiving intravenous ganciclovir therapy can reduce the incidence of the hearing abnomalities and growth retardation at 6 and 12 months compared with untreated infants.ConclusionsDrug therapy for CMV diseases in infants is still lack of consistent and common regimens, and the efficacy and safety of ganciclovir remains controversical in the current.This study found that ganciclovir can improve the clinical symptoms and signs, inhibit CMV replication, and to some extent can prevent deterioration of hearing loss and growth retardation in infants with CMV infection. Because the study is limited to the original quality, quantity as well as the differences between the treatment programs of the study, the above conclusion only for clinicians to reference.Nevertheless, more multi-center, large-scale RCTs are still needed to get more high-quality EBM evidence that to update this system. In addition, other drug regimens were limited to no randomized control trials and difficult to evaluate.