Clinical impact of ganciclovir-resistant cytomegalovirus infections in solid organ transplant patients.
Clinical consequences of ganciclovir resistant cytomegalovirus (CMV) infections were studied during 2 large prophylactic trials consisting of 100 days of valganciclovir or ganciclovir prophylaxis in solid organ transplant (SOT) recipients. The first one involved 301 high-risk (CMV donor seropositive/recipient seronegative) SOT recipients excluding lung transplants followed for 12 months, whereas the second one involved 80 lung transplant patients evaluated over 6 months. Among the 7 patients (4 non-lung and 3 lung transplant patients) carrying viruses with known ganciclovir-resistance [corrected] mutations in blood, adverse clinical outcome was only observed in the lung transplant recipients. Additionally, no CMV resistance mutations were observed in non-lung transplant patients receiving valganciclovir.
Boivin
G
G
Research Center in Infectious Diseases of the CHUQ-CHUL and Laval University, Quebec City, Quebec, Canada. guy.boivin@crchul.ulaval.ca
Goyette
N
N
Gilbert
C
C
Humar
A
A
Covington
E
E
D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018890:Chemoprevention; D003587:Cytomegalovirus / Q000187:drug effects / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000821:virology; D024882:Drug Resistance, Viral / Q000235:genetics; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D009154:Mutation; D016377:Organ Transplantation / Q000009:adverse effects*; D016896:Treatment Outcome; D000077562:Valganciclovir
D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir