title: Novel mutation in the CMV UL97 gene associated with resistance to ganciclovir therapy.
abstract: Cytomegalovirus (CMV) strains resistant to ganciclovir have been associated with specific mutations in the UL97 and UL54 genes. The UL97 gene of a CMV strain isolated from a renal transplant recipient before and after 438 days of ganciclovir treatment was amplified by polymerase chain reaction and sequenced. A novel mutation resulting in deletion of codons 595 to 603 was identified in the viral DNA from specimens obtained after, but not before, prolonged ganciclovir therapy. Clinical and virological resolution of CMV disease occurred after switching to foscarnet therapy. Although many ganciclovir resistance mutations have been mapped to the UL97 codon range 591-607, this one is unusual in that it involves deletion of half these codons. Because UL97 seems to be necessary for effective CMV replication, this deletion suggests that much of codons 591-607 can be removed without destroying the biological function of UL97, and that this codon range can be altered in various ways to affect ganciclovir susceptibility. Rapid, flexible genotypic assays directed at this part of UL97 may facilitate the early recognition of ganciclovir resistance.
authors: Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55905, USA.
authors: J C
authors: JC
authors: Mendez
authors: I G
authors: IG
authors: Sia
authors: K R
authors: KR
authors: Tau
authors: M J
authors: MJ
authors: Espy
authors: T F
authors: TF
authors: Smith
authors: S
authors: S
authors: Chou
authors: C V
authors: CV
authors: Paya
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002874:Chromosome Mapping; D003062:Codon; D003106:Colon / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000188:drug therapy; D004351:Drug Resistance / Q000235:genetics; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D009154:Mutation; D017853:Phosphotransferases (Alcohol Group Acceptor) / Q000235:genetics*; D016133:Polymerase Chain Reaction
chemical_list: D000998:Antiviral Agents; D003062:Codon; D017853:Phosphotransferases (Alcohol Group Acceptor); C075365:ganciclovir kinase; D015774:Ganciclovir