Ganciclovir-resistant cytomegalovirus infection in solid organ transplant recipients: a single-center retrospective cohort study

P. G. Young, J. Rubin, M. Angarone, J. Flaherty, S. Penugonda, V. Stosor, M. G. Ison*

*Corresponding author for this work

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Background: Ganciclovir-resistant cytomegalovirus (GCV-R CMV) is an emerging challenge among solid organ transplant (SOT) recipients. The literature suggests that about 1% of abdominal transplant recipients develop GCV-R CMV infection. The epidemiology and outcome of GCV-R CMV in SOT recipients who have received alemtuzumab induction is not well described. Methods: After Institutional Review Board approval, a single-center, retrospective review of 2148 abdominal SOT recipients between January 2006 and July 2011 at our institution (n = 2148) was conducted to identify patients with proven or empirically treated GCV-R CMV. Descriptive statistics on collected demographics, clinical course, and therapeutic outcomes were performed. Results: Of 116 SOT recipient treated for CMV, 14 patients (12.1% of cases; 0.65% of all SOT patients) had proven or suspected GCV-R CMV. Eight (50%) developed GCV-R CMV while receiving valganciclovir (valGCV) prophylaxis. The remainder developed late-onset disease, after having completed an average 212 days (range 83–353) of prophylaxis. Resistance was clinically suspected an average of 103 days (range 10–455) after CMV infection was initially identified; 10 patients had confirmed genotypic resistance. Foscarnet therapy was associated with resolution of CMV in 13. Conclusion: Suboptimal dosing of valGCV is associated with development of GCV-R CMV. Our observed rate of GCV-R CMV in alemtuzumab-induced patients is similar to rates seen to historical data for other induction agents.

Original languageEnglish (US)
Pages (from-to)390-395
Number of pages6
JournalTransplant Infectious Disease
Volume18
Issue number3
DOIs
StatePublished - Jun 1 2016

Keywords

  • abdominal transplant
  • cytomegalovirus
  • ganciclovir-resistance
  • solid organ transplant

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

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