Abstract
Drug-resistant cytomegalovirus (CMV) should be considered when viral shedding persists after several weeks of therapy. The problem is most likely to arise in the setting of a severely immunosuppressed host with continuing or relapsing disease. Not all treatment failure can be attributed to drug resistance. The testing of CMV isolates for drug resistance in cell culture is time-consuming and labor-intensive, but recent advances in understanding of the genetics of resistance have resulted in rapid genotypic assays for specific mutations in the viral UL97 phosphotransferase or UL54 DNA polymerase genes that can predict resistance and cross-resistance to specific drugs. This information may help in the selection of alternative therapy.
Publication types
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Research Support, U.S. Gov't, Non-P.H.S.
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Research Support, U.S. Gov't, P.H.S.
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Review
MeSH terms
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Antiviral Agents / pharmacology
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Antiviral Agents / therapeutic use*
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Cytomegalovirus / drug effects
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Cytomegalovirus / genetics*
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Cytomegalovirus / isolation & purification
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Cytomegalovirus Infections / drug therapy*
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Cytomegalovirus Infections / physiopathology
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DNA-Directed DNA Polymerase / genetics
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Drug Resistance, Microbial*
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Humans
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Immunocompromised Host
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Mutation
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Phosphotransferases (Alcohol Group Acceptor) / genetics
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Viral Proteins*
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Virus Shedding
Substances
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Antiviral Agents
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UL54 protein, Human herpesvirus 5
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Viral Proteins
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Phosphotransferases (Alcohol Group Acceptor)
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ganciclovir kinase
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DNA-Directed DNA Polymerase