RT Journal Article
T1 Detection of cytomegalovirus drug resistance mutations in solid organ transplant recipients with suspected resistance.
A1 Lopez-Aladid, Ruben
A1 Guiu, Alba
A1 Sanclemente, Gemma
A1 Lopez-Medrano, Francisco
A1 Cofan, Frederic
A1 Mosquera, M Mar
A1 Torre-Cisneros, Julian
A1 Vidal, Elisa
A1 Moreno, Asuncion
A1 Aguado, Jose Maria
A1 Cordero, Elisa
A1 Martin-Gandul, Cecilia
A1 Perez-Romero, Pilar
A1 Carratala, Jordi
A1 Sabe, Nuria
A1 Niubo, Jordi
A1 Cervera, Carlos
A1 Cervilla, Anna
A1 Bodro, Marta
A1 Muñoz, Patricia
A1 Fariñas, Carmen
A1 Codina, M Gemma
A1 Aranzamendi, Maitane
A1 Montejo, Miguel
A1 Len, Oscar
A1 Marcos, M Angeles
K1 Cytomegalovirus
K1 Genotypic analysis
K1 Solid organ transplantation
K1 Suspected resistance
AB Current guidelines recommend that treatment of resistant cytomegalovirus (CMV) in solid organ transplant (SOT) recipients must be based on genotypic analysis. However, this recommendation is not systematically followed. To assess the presence of mutations associated with CMV resistance in SOT recipients with suspected resistance, their associated risk factors and the clinical impact of resistance. Using Sanger sequencing we prospectively assessed the presence of resistance mutations in a nation-wide prospective study between September 2013-August 2015. Of 39 patients studied, 9 (23%) showed resistance mutations. All had one mutation in the UL 97 gene and two also had one mutation in the UL54 gene. Resistance mutations were more frequent in lung transplant recipients (44% p=0.0068) and in patients receiving prophylaxis ≥6 months (57% vs. 17%, p=0.0180). The mean time between transplantation and suspicion of resistance was longer in patients with mutations (239 vs. 100days, respectively, p=0.0046) as was the median treatment duration before suspicion (45 vs. 16days, p=0.0081). There were no significant differences according to the treatment strategies or the mean CMV load at the time of suspicion. Of note, resistance-associated mutations appeared in one patient during CMV prophylaxis and also in a seropositive organ recipient. Incomplete suppression of CMV was more frequent in patients with confirmed resistance. Our study confirms the need to assess CMV resistance mutations in any patient with criteria of suspected clinical resistance. Early confirmation of the presence of resistance mutations is essential to optimize the management of these patients.
PB Elsevier
YR 2017
FD 2017-03-16
LK http://hdl.handle.net/10668/11026
UL http://hdl.handle.net/10668/11026
LA en
NO López-Aladid R, Guiu A, Sanclemente G, López-Medrano F, Cofán F, Mosquera MM, et al. Detection of cytomegalovirus drug resistance mutations in solid organ transplant recipients with suspected resistance. J Clin Virol. 2017 May;90:57-63
DS RISalud
RD Apr 12, 2025