A Randomized, Phase I/II Trial to Assess the Safety and Antiviral Effects of Escalating Doses of A Human Anti-Cytomegalovirus Monoclonal Antibody (SDZ MSL-109) in Patients With the Acquired Immunodeficiency Syndrome and CMV Viremia and/or Viruria

Inclusion Criteria Concurrent Medication: Allowed: Zidovudine (AZT). Acyclovir. Experimental maintenance or prophylactic therapy with an approved therapeutic agent for a non-viral opportunistic infection. Trimethoprim / sulfamethoxazole (TMP / SMX). Pyrimethamine / sulfadoxine. Inhaled pentamidine. Amphotericin B. Ketoconazole. Flucytosine (5-FC). Antituberculosis therapy. Recombinant human erythropoietin. Recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF). Recombinant human interferon alfa 2 for AIDS-related Kaposi's sarcoma. Patients must have: AIDS or be HIV positive with CD4 lymphocyte counts below 200 cells/mm3 and be receiving prophylaxis for Pneumocystis carinii pneumonia (PCP) (with or without prophylaxis for another opportunistic infection), but have no prior medical history of an opportunistic infection. Expected survival of = or > 6 months. Willingness and ability to give written informed consent. A copy of the signed and witnessed consent form must be maintained with the investigator's study files. Positive culture results documenting the presence of cytomegalovirus (CMV) viremia and/or viruria. Seropositive for the presence of circulating anti-CMV immunoglobulin. Exclusion Criteria Co-existing Condition: Patients with the following conditions or symptoms are excluded: Significant pulmonary dysfunction. Uncontrolled or unstable diabetes. Significant cardiovascular disease including uncontrolled hypertension, congestive heart failure, cardiac arrhythmia, angina pectoris, or a history of myocardial infarction within one year of entry into the study. Coagulation or hemorrhagic disorders. Any active severe opportunistic infection. Concurrent Medication: Excluded: Therapy with ganciclovir (DHPG) or phosphonoformate (PFA) or other experimental anti-cytomegalovirus therapy except as stipulated in this protocol. Any other experimental antiviral therapy. Biologicals including immunoglobulin therapy (except those patients randomized to receive Sandoglobulin as specified in this protocol). Patients with the following are excluded: Any significant organ system dysfunction as described in Exclusion co-existing conditions. Previous history of or evidence of idiopathic thrombocytopenia purpura, agammaglobulinemia, or hypogammaglobulinemia. Any other severe concomitant clinical condition. Documented, active cytomegalovirus (CMV) disease (tissue or organ invasion/dysfunction) at baseline. To this end, baseline indirect funduscopy (to detect and exclude patients with peripheral CMV retinitis) will be performed. Prior Medication: Excluded within 2 weeks of study entry: Therapy with ganciclovir (DHPG) or phosphonoformate (PFA) or other experimental anti-cytomegalovirus therapy except as stipulated in this protocol. Any other experimental antiviral therapy. Biologicals including immunoglobulin therapy (except those patients randomized to receive Sandoglobulin as specified in this protocol). Excluded: Prior treatment with monoclonal antibodies derived from any animal species. Prior Treatment: Excluded within 2 weeks of study entry: Major surgery.