Detection of ganciclovir resistance after valacyclovir-prophylaxis in renal transplant recipients with active cytomegalovirus infection

被引:31
作者
Alain, S
Hantz, S
Scieux, C
Karras, A
Mazeron, MC
Szelag, JC
Imbert, BM
Fillet, AM
Gouarin, S
Mengelle, C
de Wilde, A
Cogne, N
Champier, G
Rogez, S
Legendre, C
Denise, F
机构
[1] Teaching Hosp Dupuytren, Dept Bacteriol Virol Hyg, EA, Limoges, France
[2] Teaching Hosp St Louis, Dept Nephrol, Paris, France
[3] Teaching Hosp St Louis, Dept Bacteriol Virol, Paris, France
[4] Teaching Hosp Lariboisiere, Dept Bacteriol Virol, Paris, France
[5] Teaching Hosp Dupuytren, Dept Nephrol, Limoges, France
[6] Teaching Hosp, Dept Virol, Nantes, France
[7] Teaching Hosp Pitie Salpetriere, Dept Virol, Paris, France
[8] Teaching Hosp Caen, Caen, France
[9] Teaching Hosp Purpan, Dept Virol, Toulouse, France
[10] Teaching Hosp Lille, Dept Virol, Lille, France
关键词
human cytomegalovirus; ganciclovir resistance; valaciclovir transplantation;
D O I
10.1002/jmv.20127
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Whether valaciclovir(VCV) prophylaxis could be responsible for ganciclovir (GCV)-resistance of Human cytomegalovirus (HCMV) in transplantation has never been documented. A multicentric retrospective pilot study was undertaken to detect GCV-resistance through mutations within the UL97 gene in renal transplant recipients who experienced active HCMV infection and received valacyclovir prophylaxis. Twenty-three patients who experienced HCMV antigenaemia or DNAemia during or at the end of prophylaxis were included. UL97 genotyping was carried out on peripheral blood samples, using a nested in-house PCR, which amplified the full-length UL97 gene. One patient has a resistance-related mutation (M4601); the major risk factor for emergence of resistance in this patient was the presence of early and persistent antigenaemia. GCV-resistance during VCV-prophylaxis was rare after renal transplantation. However, special attention must be paid to patients developing early active HCMV infection under prophylaxis. (C) 2004 Wiley-Liss, Inc.
引用
收藏
页码:566 / 573
页数:8
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