Probable reactivation from latency of multi-drug resistant cytomegalovirus in a lung transplant recipient: a case report. (PubMed, Am J Transplant) - Aug 25, 2025 - "Whether ganciclovir-resistant cytomegalovirus (ganR-CMV) can establish latency and reactivate absent any selective drug pressure is unknown and has implications for selecting empiric antiviral therapy in patients with prior ganR-CMV...Foscarnet therapy led to CMV DNAemia clearance and disease resolution...Valganciclovir was given for three days post-transplant, then switched to letermovir prophylaxis for three months...These unusual circumstances suggest establishment of latency with an antiviral-resistant CMV strain and subsequent late reactivation during augmented immunosuppression at the time of a new kidney transplant. Genotypic antiviral resistance testing should be considered even in cases of remote, resolved ganR-CMV infection to guide appropriate antiviral therapy."
Journal • Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Solid Organ Transplantation • Transplantation
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Adrian M Whelan; Ajit P Limaye; Brian S Schwartz; Helen C Stankiewicz Karita; Julia A Wagner; Rama Yakubu; Steven R Hays
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