Abstract
Objective: Intravenous ganciclovir and oral valganciclovir are known to have severe side effects against hematopoiesis and kidney function. This study aims to look for these side effects in pediatric patients with cytomegalovirus (CMV) infection treated with ganciclovir or a combination regimen of both in Hasan Sadikin General Hospital, a tertiary care center in West Java, Indonesia.
 Methods: This was a cross-sectional study using medical records and laboratory examination data from pediatric patients with CMV infection who received ganciclovir of 6 mg/kg twice a day, valganciclovir of 16 mg/kg twice a day, or a combination of both in Hasan Sadikin General Hospital from January 2015 to January 2019. Differences before and after therapy were analyzed to look for any side effects in each regimen and duration of therapy.
 Results: Out of 115 patients, there were 53 subjects who met the research criteria. Majority of the subjects used a combination regimen (n=29, 55%) for 6 weeks (n=36, 68%). There was no statistically significant difference (p>0.05) in the incidence of anemia, neutropenia, thrombocytopenia, increase in creatinine serum, or increase in blood urea nitrogen for different regimen or duration of therapy.
 Conclusion: No side effects were found to be related with therapeutic regimen or duration of therapy in pediatric patients with CMV infection in this study.
Highlights
Cytomegalovirus (CMV) is a double-stranded deoxyribonucleic acid (DNA) virus that belongs to the Herpesviridae family and may infect any age group [1]
Ganciclovir is an antiviral that works by preventing CMV DNA replication
As far as we know, there have been no studies of the side effects of ganciclovir, valganciclovir, or combination regimen done in developing countries; this study aims to look for these side effects in pediatric patients with CMV infection admitted to Hasan Sadikin General Hospital to become the basis for clinical guidance of pediatric CMV infection in developing countries
Summary
Cytomegalovirus (CMV) is a double-stranded deoxyribonucleic acid (DNA) virus that belongs to the Herpesviridae family and may infect any age group [1]. The prevalence of CMV infection is said to be higher in children with low socioeconomic status and those living in developing countries [2,3]. Ganciclovir is an antiviral that works by preventing CMV DNA replication. Intravenous ganciclovir therapy for 6 weeks provides shortterm clinical improvement and better neurological development [6,7,8]. Valganciclovir is the valine ester form of ganciclovir which will be converted into its active form in intestinal and liver epithelial cells [9,10]. Oral valganciclovir is said to have the same efficacy and pharmacokinetic properties with intravenous ganciclovir [7,11,12,13]
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