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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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Thereof, development of a mutation of the CMV UL56 terminase (UL-56-Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). |
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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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-
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Clinical and Epidemiological Correlations
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Clinical Information
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Y |
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Treatment
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letermovir |
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Location
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- |
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Literature Information
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PMID
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34118118
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Title
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Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study
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Author
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Veit T,Munker D,Barton J,Milger K,Kauke T,Meiser B,Michel S,Zoller M,Nitschko H,Keppler OT,Behr J,Kneidinger N
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Journal
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American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
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Journal Info
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2021 Oct;21(10):3449-3455
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Abstract
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Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between March 2018 and August 2020, who have been treated with letermovir for ganciclovir-resistant or refractory CMV infection were included in the study and analysed retrospectively. In total, 28 patients were identified. CMV disease was present in 15 patients (53.6%). In 23 patients (82.1%), rapid response was noticed, and CMV-viral load could be significantly decreased (>1 log(10) ) after a median of 17 [14-27] days and cleared subsequently in all of these patients. Five patients (17.9%) were classified as non-responder. Thereof, development of a mutation of the CMV UL56 terminase (UL-56-Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). Common side effects were mild and mostly of gastrointestinal nature. Mild adjustments of the immunosuppressive drugs were mandatory upon treatment initiation with letermovir. In addition to other interventions, letermovir was effective in difficult to treat CMV infections in lung transplant recipients. However, in patients with treatment failure mutation conferring letermovir, resistance should be taken into account.
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Sequence Data
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-
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