Assay of cytomegalovirus susceptibility to ganciclovir in renal and heart transplant recipients

Ganciclovir (GCV) prophylaxis or pre-emptive therapy significantly reduce the rate of cytomegalovirus (CMV) disease and viremia, but increase the potential for emergence of ganciclovir-resistant CMV strains. The inhibitor concentration at 50% (IC(50)) of GCV from 156 CMV isolates from 59 renal or he...

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Published inTransplant international Vol. 15; no. 11; pp. 570 - 573
Main Authors NAVARRO, Maria De, MELON, Santiago, MENDEZ, Susana, IGLESIAS, Beatriz, PALACIO, Ana, BERNARDO, Maria J, RODRIGUEZ-LAMBERT, José L, GOMEZ, Ernesto
Format Journal Article
LanguageEnglish
Published Oxford Blackwell Publishing 01.11.2002
Blackwell Publishing Ltd
Subjects
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Antiviral Agents - pharmacology
Biological and medical sciences
Cytomegalovirus - drug effects
Cytomegalovirus - genetics
Drug Resistance, Microbial
Ganciclovir - pharmacology
Heart Transplantation
Humans
Kidney Transplantation
Medical sciences
Microbial Sensitivity Tests
Pharmacology. Drug treatments
Phenotype
Heart
Human
Acyclic nucleoside
Purine nucleoside
Drug susceptibility test
Herpesviridae
Transplantation
Recipient
Homotransplantation
Betaherpesvirinae
Kidney
Human cytomegalovirus
Virus
Prevention
Chemotherapy
Ganciclovir
Treatment
Surgery
Antiviral
Graft
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Summary:Ganciclovir (GCV) prophylaxis or pre-emptive therapy significantly reduce the rate of cytomegalovirus (CMV) disease and viremia, but increase the potential for emergence of ganciclovir-resistant CMV strains. The inhibitor concentration at 50% (IC(50)) of GCV from 156 CMV isolates from 59 renal or heart transplant recipients was calculated by means of a rapid phenotypic susceptibility assay. Twenty-seven strains were from 14 patients undergoing GCV therapy. The IC(50) was higher in patients under the prophylaxis regimen. One CMV strain, from a heart transplant recipient, became GCV-resistant after 1 month of therapy (IC(50)=13.7 micromol/l). These data, together with clinical and virological markers, suggested that a switch to foscarnet was necessary, and good evolution was observed. Thus, assay of CMV susceptibility to GCV could be helpful in clinical management.
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ISSN:0934-0874
1432-2277
DOI:10.1007/s00147-002-0453-6