Absence of cytomegalovirus-resistance mutations after valganciclovir prophylaxis, in a prospective multicenter study of solid-organ transplant recipients.
We investigated the emergence of cytomegalovirus (CMV) ganciclovir-resistance mutations in 301 high-risk solid-organ transplant (SOT) recipients after oral prophylaxis, for 100 days, with either valganciclovir or ganciclovir. For patients treated with ganciclovir, the incidence of CMV UL97 mutations was 1.9% (2/103) at the end of prophylaxis and 6.1% (2/33) for patients with suspected CMV disease up to 1 year after transplantation. No resistance mutations were detected in samples from valganciclovir-treated patients. Dual polymerase (UL54) and UL97 resistance mutations were not seen. Valganciclovir was associated with negligible risk of resistance and thus constitutes a useful alternative to ganciclovir prophylaxis for CMV in high-risk SOT recipients.
Boivin
Guy
G
Research Center in Infectious Diseases, Centre Hospitalier Universitaire de Quebec and Laval University, Quebec City, Canada. guy.boivin@crchul.ulaval.ca.
Goyette
Nathalie
N
Gilbert
Christian
C
Roberts
Noel
N
Macey
Katherine
K
Paya
Carlos
C
Pescovitz
Mark D
MD
Humar
Atul
A
Dominguez
Ed
E
Washburn
Kenneth
K
Blumberg
Emily
E
Alexander
Barbara
B
Freeman
Richard
R
Heaton
Nigel
N
Covington
Emma
E
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018890:Chemoprevention; D003587:Cytomegalovirus / Q000187:drug effects* / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000517:prevention & control* / Q000821:virology; D004311:Double-Blind Method; D024882:Drug Resistance, Viral / Q000235:genetics*; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009154:Mutation; D016377:Organ Transplantation; D011446:Prospective Studies; D016896:Treatment Outcome; D000077562:Valganciclovir
D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir