Cytomegalovirus Infection and Rates of Antiviral Resistance Following Intestinal and Multivisceral Transplantation

Ambrose, Tim; Sharkey, Lisa; Louis-Auguste, John; Rutter, Charlotte; Duncan, Samantha; English, Suzanne; Gkrania‐Klotsas, Effrossyni; Carmichael, Andrew; Woodward, J; Russell, Neil; Massey, Dunecan; Butler, Andrew; Middleton, S

doi:10.1016/j.transproceed.2015.09.070

Cited by 23 publications

(9 citation statements)

References 24 publications

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“…276,277 Among solid organ recipients the usual incidence of resistance after GCV therapy is 5% to 12%, [278][279][280] but up to 18% in lung, 275,281 and 31% in intestinal and multivisceral organ transplant recipients. 282,283 The incidence of resistance is lower, in the 0% to 3% range, for 100 to 200 days of GCV or VGCV prophylaxis in D+/R− kidney recipients. 284 A higher incidence of GCV resistance has sometimes been reported with preemptive therapy as compared with prophylaxis where no viral load is expected at baseline.…”

Section: Risk Factors Frequency and Clinical Consequencesmentioning

confidence: 99%

The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation

et al. 2018

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Despite recent advances, cytomegalovirus (CMV) infections remain one of the most common complications affecting solid organ transplant recipients, conveying higher risks of complications, graft loss, morbidity, and mortality. Research in the field and development of prior consensus guidelines supported by The Transplantation Society has allowed a more standardized approach to CMV management. An international multidisciplinary panel of experts was convened to expand and revise evidence and expert opinion-based consensus guidelines on CMV management including prevention, treatment, diagnostics, immunology, drug resistance, and pediatric issues. Highlights include advances in molecular and immunologic diagnostics, improved understanding of diagnostic thresholds, optimized methods of prevention, advances in the use of novel antiviral therapies and certain immunosuppressive agents, and more savvy approaches to treatment resistant/refractory disease. The following report summarizes the updated recommendations.

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Section: Risk Factors Frequency and Clinical Consequencesmentioning

confidence: 99%

The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation

et al. 2018

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“…The emergence of CMV resistance in a patient reduces the clinical e cacy of antiviral therapy, complicates therapeutic and clinical management decisions, and, in some cases, results in death of the patient. According to recent reports, the incidence of GCV resistance is 5-12% among solid organ recipients [21][22][23] and 31% in intestinal and multivisceral organ transplant recipients 24 . GCV resistance is 7.9% in HCT recipients from matched related or unrelated donors 22,25 and 14.5% in high-risk patients 26 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of UL97 gene mutations in cytomegalovirus reactivation in the colon associated with or without ulcerative colitis

Tamura

Osawa

Ishida

et al. 2021

Preprint

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Cytomegalovirus (CMV) reactivation in the colon is common in patients with severe ulcerative colitis (UC). Ganciclovir (GCV) resistance conferring CMV UL97 gene mutations have been reported in recent years. However, the prevalence of UL97 gene mutations in GCV-naive CMV infection in the colon remains unknown. We investigated the prevalence of CMV UL97 gene mutations in patients with colonic CMV infection associated with or without UC. Twenty-two GCV-naive patients with colonic CMV infection, 15 with UC and 7 with other diseases, were enrolled. Frozen biopsy samples or formalin-fixed paraffin-embedded samples were used for nested polymerase chain reaction (PCR) amplification of the UL97 gene. Sanger DNA sequencing was performed. UL97 mutations were frequently detected in codons T75A (95.5%), Q126L (86.4%), and D605E (86.4%), and less frequently (< 10%) in L228P, D263G, A53S, R137C, A140V, G188S, A674T, and T675A. However, no known GCV resistance mutations were found. There seemed to be no difference between the ratio of mutations in patients with and without UC. In conclusions, we did not detect UL97 gene mutations associated with GCV resistance in GCV-naive patients with or without UC. T75A, Q126L, and D605E mutations may be used as genetic markers for CMV in East Asian countries.

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“…The emergence of CMV resistance in a patient reduces the clinical e cacy of antiviral therapy, complicates therapeutic and clinical management decisions, and, in some cases, results in death of the patient. According to recent reports, the incidence of GCV resistance is 5-12% among solid organ recipients [20][21][22] and 31% in intestinal and multivisceral organ transplant recipients [23]. GCV resistance is 7.9% in HCT recipients from matched related or unrelated donors [21,24] and 14.5% in high-risk patients [25].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of UL97 gene mutations in cytomegalovirus reactivation in the colon associated with or without ulcerative colitis

Tamura

Osawa

Ishida

et al. 2020

Preprint

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Background: Cytomegalovirus (CMV) reactivation in the colon is common in patients with severe ulcerative colitis (UC) and in immunocompromised patients, and may be associated with poor prognosis. Ganciclovir (GCV) resistance conferring CMV UL97 gene mutations have been reported in recent years. However, the prevalence of UL97 gene mutations in GCV-naive CMV colitis remains to date unknown. The present study aimed to investigate the prevalence of CMV UL97 gene mutations in Japanese patients with colonic CMV infection associated with or without UC.Methods: Twenty-two GCV-naive patients with colonic CMV infection, 15 with UC and 7 with other diseases, were enrolled. Frozen biopsy samples or formalin-fixed paraffin-embedded samples were used for nested polymerase chain reaction (PCR) amplification of the UL97 gene. Sanger DNA sequencing of the PCR products was performed.Results: UL97 mutations were frequently detected in codons T75A (95.5%), Q126L (86.4%), and D605E (86.4%), and less frequently (<10%) in L228P, D263G, A53S, R137C, A140V, G188S, A674T, and T675A. However, no known GCV resistance mutations were found. There was no significant difference between the ratio of mutations in patients with and without UC.Conclusions: We did not detect UL97 gene mutations associated with GCV resistance in GCV-naive patients with or without UC. In contrast, T75A, Q126L, and D605E mutations may be used as genetic markers for CMV in East Asian countries.

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Cytomegalovirus Infection and Rates of Antiviral Resistance Following Intestinal and Multivisceral Transplantation

Cited by 23 publications

References 24 publications

The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation

The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation

Prevalence of UL97 gene mutations in cytomegalovirus reactivation in the colon associated with or without ulcerative colitis

Prevalence of UL97 gene mutations in cytomegalovirus reactivation in the colon associated with or without ulcerative colitis

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