Emergence of letermovir resistance in solid organ transplant recipients with ganciclovir resistant cytomegalovirus infection: A case series and review of the literature.

Details

Serval ID
serval:BIB_E88187EC061E
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Emergence of letermovir resistance in solid organ transplant recipients with ganciclovir resistant cytomegalovirus infection: A case series and review of the literature.
Journal
Transplant infectious disease
Author(s)
Hofmann E., Sidler D., Dahdal S., Bittel P., Suter-Riniker F., Manuel O., Walti L.N., Hirzel C.
ISSN
1399-3062 (Electronic)
ISSN-L
1398-2273
Publication state
In Press
Peer-reviewed
Oui
Pages
e13515
Language
english
Notes
Publication types: Case Reports
Publication Status: aheadofprint
Abstract
Ganciclovir (GCV)-resistant cytomegalovirus (CMV) infection is a common problem among solid organ transplant (SOT) recipients without prior CMV immunity (CMV D+/R-). GCV-resistant CMV represents a particular challenge for CMV management. Letermovir is a recently licensed antiviral agent for primary CMV prophylaxis in allogenic hematopoietic stem cell transplant (HSCT) recipients. Given the favorable safety profile and its oral bioavailability letermovir may be considered a valuable off-label option for secondary prophylaxis of GCV-resistant CMV in SOT recipients. Here, we describe our experience with letermovir as secondary prophylaxis for GCV-resistant CMV in two renal transplant recipients and review the literature in regard of previously published cases. Letermovir resistance emerged after a few months of secondary prophylaxis in the two renal transplant recipients. In both cases, the previously described UL56 C325Y letermovir resistance mutation was detected. In vitro studies of letermovir suggest a relatively low genetic barrier to resistance. Therefore, caution is warranted when using letermovir as secondary prophylaxis for GCV-resistant CMV infection.
Keywords
Letermovir resistance, human cytomegalovirus infection (CMV), secondary CMV prophylaxis, solid organ transplant, letermovir resistance
Pubmed
Web of science
Open Access
Yes
Create date
28/11/2020 10:03
Last modification date
04/08/2022 5:39
Usage data