Immune-based guidance of foscarnet treatment duration in a transplant recipient with ganciclovir-resistant cytomegalovirus infection

Janine Mihm; Sarah Leyking; Jan Dirks; Sigrun Smola; Danilo Fliser; Urban Sester; Martina Sester; Heinrike Wilkens; Jürgen Rissland

doi:10.1016/j.jcv.2016.06.013

Immune-based guidance of foscarnet treatment duration in a transplant recipient with ganciclovir-resistant cytomegalovirus infection

J Clin Virol. 2016 Sep:82:5-8. doi: 10.1016/j.jcv.2016.06.013. Epub 2016 Jun 22.

Authors

Janine Mihm¹, Sarah Leyking¹, Jan Dirks², Sigrun Smola³, Danilo Fliser¹, Urban Sester¹, Martina Sester⁴, Heinrike Wilkens⁵, Jürgen Rissland³

Affiliations

¹ Department of Internal Medicine IV, Saarland University, D-66421 Homburg, Germany.
² Department of Transplant and Infection Immunology, Saarland University, D-66421 Homburg, Germany.
³ Institute of Virology, Saarland University, D-66421 Homburg, Germany.
⁴ Department of Transplant and Infection Immunology, Saarland University, D-66421 Homburg, Germany. Electronic address: martina.sester@uks.eu.
⁵ Department of Internal Medicine V, Saarland University, D-66421 Homburg, Germany.

PMID: 27389910
DOI: 10.1016/j.jcv.2016.06.013

Abstract

A lung and kidney transplant recipient underwent cytomegalovirus (CMV) primary infection with a UL97 mutation. Combined monitoring of viral load and CMV-specific CD4 T-cells allowed reduction of treatment duration with foscarnet, and illustrates how knowledge on the individual immunocompetence towards CMV may be used to individualize duration of antiviral treatment.

Keywords: Antiviral therapy; Cytomegalovirus; Resistance; Solid organ transplantation; T-cell.

Publication types

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

MeSH terms

Adult
Antiviral Agents / administration & dosage*
Antiviral Agents / pharmacology
CD4-Positive T-Lymphocytes / immunology
Cytomegalovirus / drug effects*
Cytomegalovirus Infections / drug therapy*
Cytomegalovirus Infections / virology
Drug Monitoring / methods*
Drug Resistance, Viral*
Female
Foscarnet / administration & dosage*
Ganciclovir / pharmacology
Humans
Kidney Transplantation
Lung Transplantation
Transplant Recipients
Viral Load

Substances

Antiviral Agents
Foscarnet
Ganciclovir