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Detection of ganciclovir resistance after valacyclovir‐prophylaxis in renal transplant recipients with active cytomegalovirus infection

2004; Wiley; Volume: 73; Issue: 4 Linguagem: Inglês

10.1002/jmv.20127

1096-9071

Sophie Alain, Sébastien Hantz, Catherine Scieux, Alexandre Karras, Marie‐Christine Mazeron, Jean-Christophe Szelag, Berthe-Marie Imbert, Anne‐Marie Fillet, S. Gouarin, Catherine Mengelle, A. de Wilde, Nadine Cogné, Gaël Champier, Sylvie Ranger‐Rogez, Christophe Legendre, F. Denis,

Viral-associated cancers and disorders

Abstract Whether valaciclovir (VCV) prophylaxis could be responsible for ganciclovir (GCV)‐resistance of Human cytomegalovirus (HCMV) in transplantation has never been documented. A multicentric retrospective pilot study was undertaken to detect GCV‐resistance through mutations within the UL97 gene in renal transplant recipients who experienced active HCMV infection and received valacyclovir prophylaxis. Twenty‐three patients who experienced HCMV antigenaemia or DNAemia during or at the end of prophylaxis were included. UL97 genotyping was carried out on peripheral blood samples, using a nested in‐house PCR, which amplified the full‐length UL97 gene. One patient has a resistance‐related mutation (M460I); the major risk factor for emergence of resistance in this patient was the presence of early and persistent antigenaemia. GCV‐resistance during VCV‐prophylaxis was rare after renal transplantation. However, special attention must be paid to patients developing early active HCMV infection under prophylaxis. J. Med. Virol. 73:566–573, 2004. © 2004 Wiley‐Liss, Inc.