CMV: Laboratory Study of Etoposide

Etoposide (also called VP-16, or Vespid) is an approved drug
used in cancer chemotherapy; it can be taken orally. Now a
laboratory study has suggested that the drug might also be useful
in the treatment of CMV. ("Irreversible Inhibition of Human
Cytomegalovirus Replication by Topoisomerase II Inhibitor,
Etoposide: A New Strategy for the Treatment of Human
Cytomegalovirus Infection," by Eng-Shang Huang and others,
Antiviral Research 1992: volume 17, pages 17-32.)

The researchers reported that etoposide "can irreversibly
inhibit CMV replication at the drug concentration (2.5
micrograms/ml) greatly below toxic levels to stationary phase
cells...Because of their irreversible inhibitory effects and
approval usage in clinical oncology, it is suggested that this
group of compounds, particularly etoposide (VP-16), can be used
to control life- threatening CMV infections, such as CMV
pneumonitis and CMV retinitis, in cancer and immunocompromised
patients or patients with AIDS. "

The paper suggests that the toxicity of etoposide in this
use might be comparable to that of ganciclovir. But since its
suppression of CMV is irreversible (at least in the laboratory
tests) prolonged treatment might not be needed.

Note: Etoposide is also used for treating Kaposi's sarcoma, and
for some AIDS-related lymphomas.