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Basic Characteristics of Mutations
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Mutation Site
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C325Y |
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Mutation Site Sentence
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In both cases, the previously described UL56 C325Y letermovir resistance mutation was detected. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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UL56 |
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Standardized Encoding Gene
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UL56
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Genotype/Subtype
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- |
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Viral Reference
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-
|
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Functional Impact and Mechanisms
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Disease
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Cytomegalovirus infections
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Immune
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- |
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Target Gene
|
-
|
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Clinical and Epidemiological Correlations
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Clinical Information
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Y |
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Treatment
|
letermovir |
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Location
|
- |
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Literature Information
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PMID
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33210830
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Title
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Emergence of letermovir resistance in solid organ transplant recipients with ganciclovir resistant cytomegalovirus infection: A case series and review of the literature
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Author
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Hofmann E,Sidler D,Dahdal S,Bittel P,Suter-Riniker F,Manuel O,Walti LN,Hirzel C
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Journal
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Transplant infectious disease : an official journal of the Transplantation Society
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Journal Info
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2021 Jun;23(3):e13515
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Abstract
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Ganciclovir (GCV)-resistant cytomegalovirus (CMV) infection is a common problem among solid organ transplant (SOT) recipients without prior CMV immunity (CMV D+/R-). GCV-resistant CMV represents a particular challenge for CMV management. Letermovir is a recently licensed antiviral agent for primary CMV prophylaxis in allogenic hematopoietic stem cell transplant (HSCT) recipients. Given the favorable safety profile and its oral bioavailability letermovir may be considered a valuable off-label option for secondary prophylaxis of GCV-resistant CMV in SOT recipients. Here, we describe our experience with letermovir as secondary prophylaxis for GCV-resistant CMV in two renal transplant recipients and review the literature in regard of previously published cases. Letermovir resistance emerged after a few months of secondary prophylaxis in the two renal transplant recipients. In both cases, the previously described UL56 C325Y letermovir resistance mutation was detected. In vitro studies of letermovir suggest a relatively low genetic barrier to resistance. Therefore, caution is warranted when using letermovir as secondary prophylaxis for GCV-resistant CMV infection.
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Sequence Data
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-
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