Cytomegalovirus

NEW YORK, August 21 (Praxis Press). Ganciclovir prophylaxis is often prescribed in transplantation centers when solid-organ recipients or donors are seropositive for cytomegalovirus (CMV); widespread use of this drug in these immunosuppressed patients has raised concern about the emergence of ganciclovir-resistant CMV. Limaye and colleagues evaluated antiviral susceptibility in 25 of 240 patients who received liver, kidney, or pancreas transplants and who subsequently developed CMV disease. Twenty percent of all cases of CMV disease were resistant to ganciclovir. Ganciclovir-resistant CMV disease occurred in 7% of 67 seronegative recipients of organs from seropositive donors a median 10 months after transplantation; in contrast, ganciclovir-resistant CMV disease did not occur in any of the 173 seropositive recipients (p = 0.002). Ganciclovir-resistant CMV disease was more common in patients receiving transplants that required greater immunosuppression (p = 0.02) and was associated with serious clinical complications. New antiviral drugs and transplantation strategies will be needed ...