Management of multidrug-resistant CMV infection in immunocompromised patients: case report of a heart-transplant recipient and review of the literature

Antivir Ther. 2015;20(2):249-54. doi: 10.3851/IMP2818. Epub 2014 Jun 25.

Abstract

Cytomegalovirus (CMV) remains a leading cause of morbidity after solid organ transplantation. The efficiency of antivirals for the treatment of CMV infections may be hampered because of the emergence of CMV resistance to antivirals. The development of CMV multidrug resistance, which remains uncommon but does occur, constitutes a clinically challenging complication and may contribute to difficult therapeutic management and adverse clinical outcome. We report here the observation of the emergence of a multidrug-resistant CMV infection in a heart-transplant recipient and review the literature on similar cases to identify the potential strategies for the successful management of CMV multidrug resistance among immunocompromised patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • Cyclosporine / therapeutic use
  • Cytomegalovirus / drug effects*
  • Cytomegalovirus / physiology
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / virology
  • Disease Management
  • Drug Resistance, Viral
  • Everolimus / therapeutic use
  • Female
  • Foscarnet / therapeutic use
  • Ganciclovir / analogs & derivatives
  • Ganciclovir / therapeutic use
  • Heart Transplantation / adverse effects*
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Male
  • Middle Aged
  • Valganciclovir
  • Viral Load / drug effects

Substances

  • Adrenal Cortex Hormones
  • Antiviral Agents
  • Immunosuppressive Agents
  • Foscarnet
  • Cyclosporine
  • Everolimus
  • Valganciclovir
  • Ganciclovir