Outcomes of transplant recipients treated with cidofovir for resistant or refractory cytomegalovirus infection.

Transplant Infectious Disease : an Official Journal of the Transplantation Society
Seema A Mehta SteinkeRobin K Avery

Abstract

Treatment of ganciclovir-resistant (GCV-R)/refractory cytomegalovirus (CMV) infections in blood/marrow transplant (BMT) and solid organ transplant (SOT) recipients remains suboptimal. Cidofovir (CDV), a nucleotide analogue with anti-CMV activity, is nephrotoxic and oculotoxic. We retrospectively evaluated the outcomes of SOT and BMT patients with GCV-R/refractory CMV treated with CDV between 1/1/2008 and 12/31/2017. baseline demographics, CMV serostatus, clinical and virologic presentations and outcomes, UL97 and UL54 genotype mutations, drug toxicities, and cause of death. Descriptive statistics were used. 16 patients received CDV for treatment of CMV: six BMT and 10 SOT. Seven (47%) of the patients had high-risk donor/recipient serostatus: six (60%) SOT were D+/R-; one (16.7%) BMT was D-/R+. Median time to CMV DNAemia was 131 days post-transplant (IQR, 37.5-230.3). Proven tissue invasive disease was present in three patients (18.8%). Twelve (75%) had genotype testing; 10 (83.3%) of those had antiviral resistance mutations. While on CDV, six (37.5%) developed nephrotoxicity, and four (25%) developed uveitis (two had both uveitis and nephrotoxicity). Eight (50%) had failure to clear CMV DNAemia despite CDV treatment. Eight (50%...Continue Reading

References

Aug 1, 1996·Drugs·A P Lea, H M Bryson
Jan 10, 2002·Bone Marrow Transplantation·S ChakrabartiD W Milligan
Sep 14, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ajit P Limaye
Jan 22, 2003·Transplant Infectious Disease : an Official Journal of the Transplantation Society·C M IsadaR K Avery
Sep 15, 2005·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·S CesaroC Messina
Jun 29, 2007·The Lancet Infectious Diseases·Georg A FunkHans H Hirsch
Oct 12, 2010·Clinical Microbiology Reviews·Nell S Lurain, Sunwen Chou
May 13, 2011·Journal of Clinical Microbiology·Michael FormanAlexandra Valsamakis
Jun 23, 2015·Current Opinion in Infectious Diseases·Sunwen Chou
Oct 30, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Per LjungmanUNKNOWN Disease Definitions Working Group of the Cytomegalovirus Drug Development Forum
Nov 17, 2016·Surgical Infections·Hugo BonattiChristian Geltner
Apr 4, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Cynthia E FisherAjit P Limaye
Dec 7, 2017·The New England Journal of Medicine·Francisco M MartyCyrus Badshah
Dec 31, 2017·Drugs·Esther S Kim
May 5, 2018·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Klaudia NaegeleHans H Hirsch
Aug 24, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Roy F ChemalyUNKNOWN Resistant Definitions Working Group of the Cytomegalovirus Drug Development Forum

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.