A case of ganciclovir-resistant cytomegalovirus (CMV) retinitis in a patient with AIDS: longitudinal molecular analysis of the CMV viral load and viral mutations in blood compartments

AIDS
G BoivinM G Bergeron

Abstract

To study the temporal relationships between cytomegalovirus (CMV) viral load and specific UL97 mutations in polymorphonuclear leukocytes (PMNL) and plasma samples from a patient with AIDS who developed ganciclovir-resistant CMV retinitis. Sequential PMNL and plasma samples were analysed for determination of the CMV viral load using non-molecular methods and a quantitative polymerase chain reaction (PCR) assay. Screening of the same samples for the most common mutations conferring ganciclovir resistance was performed using nested PCR and restriction enzyme analysis. At the time of progression of CMV retinitis (after 6 months of ganciclovir), a rapid increase in the CMV DNA load was found in both PMNL and plasma samples. This increase paralleled the emergence of a specific mutation (V594) in the same samples and recovery of ganciclovir-resistant blood isolates. In this patient, however, the only tests that substantially predicted the progression of CMV disease were the quantitative PCR assay using PMNL and to a lesser extent the pp65 antigenemia assay. Quantitative evaluation of the CMV viral load in PMNL using sensitive assays such as PCR appears to be a promising approach for monitoring antiviral therapy in subjects with AIDS. ...Continue Reading

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Citations

Apr 10, 2004·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Tobias EckleKlaus Hamprecht
Oct 3, 1999·Journal of Virological Methods·S K Poddar
Oct 24, 1998·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·F BaldantiG Gerna
Jul 24, 2002·Drug Resistance Updates : Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy·Christian GilbertGuy Boivin
May 20, 1999·The American Journal of the Medical Sciences·D J Skiest
Dec 13, 2006·International Immunopharmacology·Eliana NogueiraAlvaro Pacheco-Silva
Oct 31, 1998·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·G Boivin
Jul 17, 1998·Clinical Microbiology Reviews·M Boeckh, G Boivin

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