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Resolution of Mild Ganciclovir-Resistant Cytomegalovirus Disease with Reduced-Dose Cidofovir and CMV-Hyperimmune Globulin
- Source :
- Journal of Transplantation, Vol 2014 (2014), Journal of Transplantation
- Publication Year :
- 2014
- Publisher :
- Hindawi Publishing Corporation, 2014.
-
Abstract
- Ganciclovir-resistant cytomegalovirus (CMV) is associated with significant morbidity in solid organ transplant recipients. Management of ganciclovir-resistant CMV may be complicated by nephrotoxicity which is commonly observed with recommended therapies and/or rejection induced by “indirect” viral effects or reduction of immunosuppression. Herein, we report a series of four high serologic risk (donor CMV positive/recipient CMV negative) kidney transplant patients diagnosed with ganciclovir-resistant CMV disease. All patients initially developed “breakthrough” viremia while still receiving valganciclovir prophylaxis after transplant and were later confirmed to exhibit UL97 mutations after failing to eradicate virus on adequate dosages of valganciclovir. The patients were subsequently and successfully treated with reduced-dose (1-2 mg/kg) cidofovir and CMV-hyperimmune globulin, given in 2-week intervals. In addition, all patients exhibited stable renal function after completion of therapy, and none experienced acute rejection. The combination of reduced-dose cidofovir and CMV-hyperimmune globulin appeared to be a safe and effective regimen in patients with mild disease due to ganciclovir-resistant CMV.
- Subjects :
- Ganciclovir
Hyperimmune globulin
biology
Article Subject
business.industry
medicine.medical_treatment
viruses
lcsh:Surgery
Congenital cytomegalovirus infection
virus diseases
Valganciclovir
Immunosuppression
Viremia
lcsh:RD1-811
medicine.disease
Nephrotoxicity
chemistry.chemical_compound
chemistry
Immunology
Clinical Study
medicine
biology.protein
business
medicine.drug
Cidofovir
Subjects
Details
- Language :
- English
- ISSN :
- 20900007
- Database :
- OpenAIRE
- Journal :
- Journal of Transplantation
- Accession number :
- edsair.doi.dedup.....d5016c485d98622ea583d7586ea1aab0
- Full Text :
- https://doi.org/10.1155/2014/342319