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

23 Citations (Scopus)

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

Fingerprint

Ganciclovir
Cytomegalovirus Infections
Cytomegalovirus
Cohort Studies
Retrospective Studies
Transplants
Foscarnet
Transplant Recipients
Research Ethics Committees
Epidemiology
Demography
Therapeutics
Infection

Keywords

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

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

@article{d04100cb6564478ea262bfcebe149253,
title = "Ganciclovir-resistant cytomegalovirus infection in solid organ transplant recipients: a single-center retrospective cohort study",
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.",
keywords = "abdominal transplant, cytomegalovirus, ganciclovir-resistance, solid organ transplant",
author = "Young, {P. G.} and J. Rubin and M. Angarone and J. Flaherty and S. Penugonda and V. Stosor and Ison, {M. G.}",
year = "2016",
month = "6",
day = "1",
doi = "10.1111/tid.12537",
language = "English (US)",
volume = "18",
pages = "390--395",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Ganciclovir-resistant cytomegalovirus infection in solid organ transplant recipients

T2 - a single-center retrospective cohort study

AU - Young, P. G.

AU - Rubin, J.

AU - Angarone, M.

AU - Flaherty, J.

AU - Penugonda, S.

AU - Stosor, V.

AU - Ison, M. G.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

KW - abdominal transplant

KW - cytomegalovirus

KW - ganciclovir-resistance

KW - solid organ transplant

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