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Cytomegalovirus DNAemia Requiring (Val)Ganciclovir Treatment for More Than 8 Weeks Is a Key Factor in the Development of Antiviral Drug Resistance

dc.rights.licenseopenen_US
dc.contributor.authorACQUIER, M.
dc.contributor.authorTATON, B.
dc.contributor.authorALAIN, S.
dc.contributor.authorGARRIGUE, I.
dc.contributor.authorMARY, J.
dc.contributor.authorPFIRMANN, P.
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
dc.contributor.authorVISENTIN, Jonathan
dc.contributor.authorHANTZ, S.
dc.contributor.authorMERVILLE, P.
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
dc.contributor.authorKAMINSKI, Hannah
dc.contributor.authorCOUZI, L.
hal.structure.identifierImmunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept]
dc.contributor.authorMERVILLE, Pierre
dc.date.accessioned2024-08-27T08:44:13Z
dc.date.available2024-08-27T08:44:13Z
dc.date.issued2023
dc.identifier.issn2328-8957en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/201312
dc.description.abstractEnBackground: Prolonged (val)ganciclovir [(V)GCV] exposure for ≥6 weeks is a known predisposing factor for cytomegalovirus (CMV) drug resistance. However, the selection of this threshold was based on limited data. In this study, we sought to reappraise the risk factors for the development of (V)GCV resistance through a specific focus on kidney transplant recipients (KTRs). Methods: This single-center retrospective study included 313 consecutive KTRs treated for a first CMV episode. Adjusted Cox multivariate regression analysis was used for identifying independent risk factors. Results: Antiviral drug resistance was identified in 20 (6%) KTRs. A cumulative (V)GCV exposure for more than 6 weeks (regardless of the viral load) was not associated with antiviral drug resistance (hazard ratio [HR] = 2.45, 95% confidence interval [CI] = 0.33-18.30, P =. 38). In contrast, persistent CMV DNAemia requiring (V)GCV treatment for more than 8 weeks was the main independent risk factor for antiviral drug resistance (HR = 11.68, 95% CI = 2.62-52.01, P =. 001). The (V)GCV treatment for more than 8 weeks was given to 9% and 18% of patients who had persistent or recurrent CMV DNAemia, respectively. These scenarios were associated with the occurrence of drug resistance in 39% and 12% of cases, respectively. Conclusions: Cumulative (V)GCV exposure ≥6 weeks regardless of the viral load is not associated with antiviral drug resistance. In contrast, prolonged exposure to (V)GCV during CMV replication (with a cutoff ³8 weeks) seems to be a key factor. © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subject.enAntiviral drug resistance
dc.subject.enCytomegalovirus
dc.subject.enKidney transplantation
dc.subject.en(val)ganciclovir
dc.title.enCytomegalovirus DNAemia Requiring (Val)Ganciclovir Treatment for More Than 8 Weeks Is a Key Factor in the Development of Antiviral Drug Resistance
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ofid/ofad018en_US
dc.subject.halSciences du Vivant [q-bio]/Immunologieen_US
dc.identifier.pubmed36817745en_US
bordeaux.journalOpen Forum Infectious Diseasesen_US
bordeaux.volume10en_US
bordeaux.hal.laboratoriesImmunoConcEpT - UMR 5164en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04678532
hal.version1
hal.date.transferred2024-08-27T08:44:15Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccCC BY-NC-NDen_US
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