Phenotype and Genotype Study of Novel C480F Maribavir-Ganciclovir Cross-Resistance Mutation Detected in Hematopoietic Stem Cell and Solid Organ Transplant Recipients.
case_report · Level V
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- Record sourced from PubMed, PMID 33475730.
- Also identified by DOI 10.1093/infdis/jiab029.
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Abstract
Two transplant recipients (1 kidney and 1 hematopoietic stem cell) received maribavir (MBV) after cytomegalovirus (CMV) infection clinically resistant to standard therapy. Both patients achieved CMV DNA clearance within 30 and 18 days; however, the UL97 C480F variant emerged, causing recurrent CMV infection after a cumulative 2 months of MBV and 15 or 4 weeks of ganciclovir treatment, respectively. C480F was not detected under ganciclovir before MBV treatment. Recombinant phenotyping showed that C480F conferred the highest level of MBV resistance and ganciclovir cross-resistance, with impaired viral growth. Clinical follow-up and genotypic and phenotypic studies are essential for the assessment and optimization of patients with suspected MBV resistance.
Medical subject headings
- Benzimidazoles
- Cytomegalovirus
- Cytomegalovirus Infections
- Drug Resistance, Viral
- Ganciclovir
- Hematopoietic Stem Cell Transplantation
- Kidney Transplantation
- Ribonucleosides
- Transplant Recipients