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lopez-aladid2017_2488.pdf (676.41 KB)

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2017-03-16

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cc by nc-nd (c) Elsevier, 2017
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/109862

Detection of cytomegalovirus drug resistance mutations in solid organ transplant recipients with suspected resistance

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http://dx.doi.org/10.1016/j.jcv.2017.03.014

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BACKGROUND: 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. OBJECTIVES: 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. STUDY DESIGN: Using Sanger sequencing we prospectively assessed the presence of resistance mutations in a nation-wide prospective study between September 2013-August 2015. RESULTS: 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. CONCLUSIONS: 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.

Matèries

Citomegalovirus, Trasplantament d'òrgans

Matèries (anglès)

Cytomegaloviruses, Transplantation of organs

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Articles publicats en revistes (ISGlobal)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

LÓPEZ ALADID, Rubén, GUIU, Alba, SANCLEMENTE, Gemma, LÓPEZ MEDRANO, Francisco, COFÁN PUJOL, Federico, MOSQUERA, Maria mar, TORRE CISNEROS, Julián, VIDAL, Elisa, MORENO CAMACHO, Ma. asunción, AGUADO, José maría, CORDERO, Elisa, MARTIN GANDUL, Cecilia, PÉREZ ROMERO, Pilar, CARRATALÀ, Jordi, SABÉ, Nuria, NIUBÓ, Jordi, CERVERA, Carlos, CERVILLA, Anna, BODRO, Marta, MUÑOZ, Patricia, FARIÑAS, María carmen, CODINA GRAU, Maria gemma, ARANZAMENDI, Maitane, MONTEJO, Miguel, LEN, Óscar, MARCOS, Ma. angeles. Detection of cytomegalovirus drug resistance mutations in solid
                organ transplant recipients with suspected resistance. _Journal of Clinical Virology_. 2017. Vol. 90, núm. 57-63. [consulta: 24 de gener de 2026]. ISSN: 1386-6532. [Disponible a: https://hdl.handle.net/2445/109862]

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