Use of Letermovir as Salvage Therapy for Drug-Resistant Cytomegalovirus Retinitis

Antimicrob Agents Chemother. 2019 Feb 26;63(3):e02337-18. doi: 10.1128/AAC.02337-18. Print 2019 Mar.

Abstract

Treatment options for drug-resistant cytomegalovirus (CMV) are limited. Letermovir is a novel antiviral recently approved for CMV prophylaxis following hematopoietic cell transplantation, but its efficacy in other settings is unknown. We recently used letermovir for salvage treatment in four solid organ transplant recipients with ganciclovir-resistant CMV retinitis. All patients improved clinically without known adverse drug events. However, three patients failed to maintain virologic suppression, including two patients who developed genotypically confirmed resistance to letermovir while on therapy.

Keywords: cytomegalovirus; ganciclovir-resistant; letermovir.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acetates / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Cytomegalovirus / drug effects*
  • Cytomegalovirus / genetics
  • Cytomegalovirus Retinitis / drug therapy*
  • Drug Resistance, Viral
  • Ganciclovir / pharmacology
  • Humans
  • Organ Transplantation / adverse effects
  • Quinazolines / therapeutic use*
  • Salvage Therapy
  • Transplant Recipients

Substances

  • Acetates
  • Antiviral Agents
  • Quinazolines
  • letermovir
  • Ganciclovir