title: Success and failure of artesunate treatment in five transplant recipients with disease caused by drug-resistant cytomegalovirus.
abstract: Cytomegalovirus (CMV) strains resistant to ganciclovir, cidofovir and/or foscarnet were genotypically and phenotypically characterised in two haematopoietic stem cell transplant recipients and three solid-organ transplant recipients with CMV disease. The anti-malaria drug artesunate led to a favourable virological and clinical response in three cases with mild CMV diseases (fever and neutropaenia) but was ineffective in two fatal CMV diseases with lung involvement in spite of a decrease in the CMV DNA load in blood and bronchoalveolar fluid.
authors.affiliation: Department of Virology, University Hospital, Grenoble, France; Unit of Virus Host Cell Interactions UMI 3265 UJF-EMBL-CNRS, B.P. 181, 6, rue Jules Horowitz, 38042 Grenoble Cedex 9, France. Electronic address: rgermi@chu-grenoble.fr.
authors.forename: R
authors.initials: R
authors.lastname: Germi
authors.affiliation: Department of Infectious diseases, University Hospital, Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariette
authors.affiliation: Department of Virology, French National Cytomegalovirus Reference Center, University Hospital, Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Alain
authors.affiliation: Department of Virology, University Hospital, Grenoble, France; Unit of Virus Host Cell Interactions UMI 3265 UJF-EMBL-CNRS, B.P. 181, 6, rue Jules Horowitz, 38042 Grenoble Cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Lupo
authors.affiliation: Department of Hematology, University Hospital, Grenoble, France.
authors.forename: A
authors.initials: A
authors.lastname: Thiebaut
authors.affiliation: Department of Infectious diseases, University Hospital, Grenoble, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Brion
authors.affiliation: Department of Virology, University Hospital, Grenoble, France; Unit of Virus Host Cell Interactions UMI 3265 UJF-EMBL-CNRS, B.P. 181, 6, rue Jules Horowitz, 38042 Grenoble Cedex 9, France; Department of Infectious diseases, University Hospital, Grenoble, France.
authors.forename: O
authors.initials: O
authors.lastname: Epaulard
authors.affiliation: Department of Pneumology, University Hospital, Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Saint Raymond
authors.affiliation: Department of Nephrology, University Hospital, Grenoble, France.
authors.forename: P
authors.initials: P
authors.lastname: Malvezzi
authors.affiliation: Department of Virology, University Hospital, Grenoble, France; Unit of Virus Host Cell Interactions UMI 3265 UJF-EMBL-CNRS, B.P. 181, 6, rue Jules Horowitz, 38042 Grenoble Cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Morand
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D000077332:Artesunate; D003587:Cytomegalovirus / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000821:virology; D024882:Drug Resistance, Viral; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects; D014180:Transplantation; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D037621:Artemisinins; D000077332:Artesunate
keywords: Artesunate; Cytomegalovirus; Multidrug resistance; Transplantation