Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene

Detalhes bibliográficos
Autor(a) principal: Peixoto, Maíra
Data de Publicação: 2012
Outros Autores: Mascarenhas, Lays, Cunha, André, Dutra, Margarida, Miranda, Eva, Silva, Ivo, Costa, Sandra, Castro Filho, Bernardo Galvão, Cunha, Andréa
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/15192
Resumo: Fundação de Amparo a Pesquisa do Estado da Bahia - FAPESB; Conselho Nacional de Pesquisa - CNPq
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spelling Peixoto, MaíraMascarenhas, LaysCunha, AndréDutra, MargaridaMiranda, EvaSilva, IvoCosta, SandraCastro Filho, Bernardo GalvãoCunha, Andréa2016-08-03T16:41:33Z2016-08-03T16:41:33Z2012PEIXOTO, M. et al. Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene. Antiviral Therapy, v. 17, p. 585-588, 2016.1359-6535https://www.arca.fiocruz.br/handle/icict/1519210.3851/IMP1938Fundação de Amparo a Pesquisa do Estado da Bahia - FAPESB; Conselho Nacional de Pesquisa - CNPqFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilHospital Portuguese. Transplantation Service Department. Salvador, BA, BrasilHospital Portuguese. Service of Nephrology. Salvador, BA, BrasilHospital Portuguese. Service of Nephrology. Salvador, BA, BrasilHospital Portuguese. Service of Nephrology. Salvador, BA, BrasilUniversidade Estadual de Campinas. Laboratório de Diagnóstico Molecular de Doenças Infecciosas. Campinas, SP, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, BrasilGanciclovir (GCV) is the first therapeutic choice for prevention and treatment of active cytomegalovirus (CMV) infection in solid organ transplant recipients in Bahia state, Brazil. Prolonged and repeated GCV therapy may result in drug-resistant virus, associated with progressive and disseminated disease. We present a case report of a young male kidney recipient, who was CMV-seronegative with a CMV-seropositive donor (D(+)/R(-)), and who developed clinical GCV resistance, confirmed by mutation in viral UL97 phosphotransferase responsible for GCV activation. Under prophylactic therapy with intravenous GCV for 6 weeks post-transplantation, he developed severe anaemia and hepatic enzyme increases, probably due to drug side effects. At this moment, the drug was discontinued and he started to be monitored by pp65 antigen test. At week 10 post-transplantation, he presented fever, myalgia, thrombocytopenia and neutropaenia, with a positive CMV antigen test. During treatment with intravenous GCV, antigenaemia assay demonstrated a higher number of positive cells, requiring GCV at higher doses. Pre-emptive therapy lasted for 31 days and he started the maintenance therapy with oral GCV. However, antigenaemia assay demonstrated an extremely high number of positive cells, and he was rehospitalized and prescribed intravenous GCV. Severe leukopaenia led to GCV interruption, but immunosuppressive dose reduction helped to control the active CMV infection. GCV-resistant CMV infection resulted in increased morbidity, rehospitalization episodes and increased costs; therefore, implementation of resistance diagnostic tests in the transplantation routine is of great importance. We documented the first case of GCV-resistant CMV infection due to the L595S mutation in UL97 phosphotransferase gene in a kidney recipient from Bahia state, Brazil.engInternational Medical PressRecurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase geneinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleAntiviral agentsCytomegalovirusCytomegalovirus infectionDrug Resistance, viralBrazilHumansKidney transplantationMaleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/15192/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALPeixoto M Recurrent....pdfPeixoto M 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dc.title.pt_BR.fl_str_mv Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
title Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
spellingShingle Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
Peixoto, Maíra
Antiviral agents
Cytomegalovirus
Cytomegalovirus infection
Drug Resistance, viral
Brazil
Humans
Kidney transplantation
Male
title_short Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
title_full Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
title_fullStr Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
title_full_unstemmed Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
title_sort Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene
author Peixoto, Maíra
author_facet Peixoto, Maíra
Mascarenhas, Lays
Cunha, André
Dutra, Margarida
Miranda, Eva
Silva, Ivo
Costa, Sandra
Castro Filho, Bernardo Galvão
Cunha, Andréa
author_role author
author2 Mascarenhas, Lays
Cunha, André
Dutra, Margarida
Miranda, Eva
Silva, Ivo
Costa, Sandra
Castro Filho, Bernardo Galvão
Cunha, Andréa
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Peixoto, Maíra
Mascarenhas, Lays
Cunha, André
Dutra, Margarida
Miranda, Eva
Silva, Ivo
Costa, Sandra
Castro Filho, Bernardo Galvão
Cunha, Andréa
dc.subject.en.pt_BR.fl_str_mv Antiviral agents
Cytomegalovirus
Cytomegalovirus infection
Drug Resistance, viral
Brazil
Humans
Kidney transplantation
Male
topic Antiviral agents
Cytomegalovirus
Cytomegalovirus infection
Drug Resistance, viral
Brazil
Humans
Kidney transplantation
Male
description Fundação de Amparo a Pesquisa do Estado da Bahia - FAPESB; Conselho Nacional de Pesquisa - CNPq
publishDate 2012
dc.date.issued.fl_str_mv 2012
dc.date.accessioned.fl_str_mv 2016-08-03T16:41:33Z
dc.date.available.fl_str_mv 2016-08-03T16:41:33Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv PEIXOTO, M. et al. Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene. Antiviral Therapy, v. 17, p. 585-588, 2016.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/15192
dc.identifier.issn.pt_BR.fl_str_mv 1359-6535
dc.identifier.doi.none.fl_str_mv 10.3851/IMP1938
identifier_str_mv PEIXOTO, M. et al. Recurrent and persistent cytomegalovirus infection in a kidney recipient caused by the L595S mutation in UL97 phosphotransferase gene. Antiviral Therapy, v. 17, p. 585-588, 2016.
1359-6535
10.3851/IMP1938
url https://www.arca.fiocruz.br/handle/icict/15192
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv International Medical Press
publisher.none.fl_str_mv International Medical Press
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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