Success and failure of artesunate treatment in five transplant recipients with disease caused by drug-resistant cytomegalovirus

Multidrug-resistant cytomegalovirus infection in a pediatric stem cell transplantation patient

“…maribavir, letermovir, brincidofovir) are studied in ongoing clinical trials (www.clinicaltrials.gov; Sellar and Peggs, 2012), this case report indicates the urgent need for the development and market availability of new anti-CMV drugs. Although additional data are required, there might be role for artesunate in the treatment of mild CMV disease due to multidrug-resistant CMV strains (Germi et al, 2014).…”

Treatment of CMV infection after allogeneic hematopoietic stem cell transplantation

“…Cell cycle modulation via cyclin-dependent kinases and retinoblastoma protein appears to play an important role in artemisinins activities [56]. Unfortunately, there is not yet a thorough evaluation of its efficacy but only sporadic reports of its in vivo anti CMV activity with contrasting results [57]. Interesting insights come from artemisinin-derived dimers, novel compounds with more potent in vitro anti-CMV effects [58,59] the efficacy of which remains to be addressed.…”

Characterization of Multiple Cytomegalovirus Drug Resistance Mutations Detected in a Hematopoietic Stem Cell Transplant Recipient by Recombinant Phenotyping

“…In general, UL54 mutations emerge after prolonged GCV exposure and thereby increase the level of GCV resistance conferred by mutations already present in the UL97 gene (6)(7)(8)(9). Infections with multidrug-resistant CMV isolates that contain several mutations in the UL97 and/or UL54 genes were reported in immunocompromised patients (10)(11)(12). Such CMV infections may be associated with a single isolate that harbors multiple mutations in the UL97 and/or UL54 genes or may result from mixed virus subpopulations that harbor different mutations (6).…”