Detection of ganciclovir resistance after valacyclovir-prophylaxis in renal transplant recipients with active cytomegalovirus infection |
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Authors: | Alain S Hantz S Scieux C Karras A Mazeron M C Szelag J C Imbert B M Fillet A M Gouarin S Mengelle C De Wilde A Cogne N Champier G Rogez S Legendre C Denis F |
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Affiliation: | Department of Bacteriology-Virology-Hygien, EA, Teaching Hospital Dupuytren, Limoges, France. sophie.alain@unilim.fr |
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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. |
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Keywords: | human cytomegalovirus ganciclovir resistance valaciclovir transplantation |
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