Absence of cytomegalovirus-resistance mutations after valganciclovir prophylaxis, in a prospective multicenter study of solid-organ transplant recipients |
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Authors: | Boivin Guy Goyette Nathalie Gilbert Christian Roberts Noel Macey Katherine Paya Carlos Pescovitz Mark D Humar Atul Dominguez Ed Washburn Kenneth Blumberg Emily Alexander Barbara Freeman Richard Heaton Nigel Covington Emma |
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Affiliation: | Research Center in Infectious Diseases, Centre Hospitalier Universitaire de Quebec and Laval University, Quebec City, Canada. guy.boivin@crchul.ulaval.ca. |
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Abstract: | We investigated the emergence of cytomegalovirus (CMV) ganciclovir-resistance mutations in 301 high-risk solid-organ transplant (SOT) recipients after oral prophylaxis, for 100 days, with either valganciclovir or ganciclovir. For patients treated with ganciclovir, the incidence of CMV UL97 mutations was 1.9% (2/103) at the end of prophylaxis and 6.1% (2/33) for patients with suspected CMV disease up to 1 year after transplantation. No resistance mutations were detected in samples from valganciclovir-treated patients. Dual polymerase (UL54) and UL97 resistance mutations were not seen. Valganciclovir was associated with negligible risk of resistance and thus constitutes a useful alternative to ganciclovir prophylaxis for CMV in high-risk SOT recipients. |
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