Emergence and persistence of multiple antiviral-resistant CMV strains in a highly immunocompromised child.
J Clin Virol
; 40(2): 152-5, 2007 Oct.
Article
en En
| MEDLINE
| ID: mdl-17698411
ABSTRACT
BACKGROUND:
The emergence of human cytomegalovirus (CMV) antiviral resistance plays a significant role in disease progression in immunocompromised patients who have received antiviral therapy.OBJECTIVES:
To determine the pattern of antiviral-resistant CMV strains in a highly immunocompromised child. STUDYDESIGN:
Retrospective specimens of blood and urine were analysed using PCR-sequencing to identify antiviral-resistant CMV strains containing UL97 or UL54 mutations.RESULTS:
CMV strains resistant to antiviral agents contributed to disease in a bone marrow transplant recipient with X-linked severe combined immunodeficiency (SCID) treated with ganciclovir (GCV) and foscarnet (FOS). Retrospective analyses detected GCV-resistant CMV (L595S) in a specimen taken after disease progression. This GCV-resistant CMV strain persisted for 1 year, after which time it was no longer detected even though the patient continued to receive GCV. A FOS-resistant strain (T700A) then emerged even though no FOS had been administered in the preceding year.CONCLUSION:
The detection of antiviral-resistant CMV did not follow the patterns found in other patients tested for antiviral resistance, including emergence of a FOS-resistant strain in the absence of antiviral-selective pressure. These findings indicate the patient's underlying immunosuppressive condition should be considered for diagnosis and management of resistant CMV.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Ganciclovir
/
Huésped Inmunocomprometido
/
Foscarnet
/
Infecciones por Citomegalovirus
/
Citomegalovirus
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Clin Virol
Asunto de la revista:
VIROLOGIA
Año:
2007
Tipo del documento:
Article
País de afiliación:
Australia