What is the first-line treatment of choice for cytomegalovirus retinitis in HIV patients?

The first-line treatment of choice for cytomegalovirus (CMV) retinitis in HIV patients is ganciclovir. Ganciclovir is an antiviral medication that is specifically effective against cytomegalovirus due to its ability to inhibit viral DNA synthesis. This mechanism is crucial in treating CMV retinitis, which can cause significant vision loss in immunocompromised patients, such as those with HIV/AIDS.

While valganciclovir is also a potent anti-CMV agent and is commonly used because of its oral bioavailability, ganciclovir is considered the standard first-line therapy, particularly when immediate treatment is necessary or in cases of severe disease. Foscarnet is an alternative treatment option, especially in cases resistant to ganciclovir, but it is not the first choice. Idoxuridine is mainly used for herpes simplex virus infections and is not typically indicated for CMV retinitis.