Suppression of CMV Infection with Letermovir in a Kidney Transplant Patient.
Suppression of CMV Infection with Letermovir in a Kidney Transplant Patient.
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DOI：
10.12890/2020_001622
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Lutz, Philipp
中科院分区：
文献类型：
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作者：
Koepf, Uta S;Klehr, Hans U;Lutz, Philipp
对更昔洛韦（GCV）具有耐药性的巨细胞病毒（CMV）感染是肾移植患者的治疗挑战，因为标准治疗方案具有肾毒性。我们报告了一例具有gcv抗性CMV疾病的肾移植受者，在该病例中，letermovir（一种新型CMV包装抑制剂）在标签外使用，一旦西多福韦减少CMV载量，就可以预防疾病复发。此外，我们观察到莱特莫韦和他克莫司之间有显著的药物相互作用。学习要点：对更昔洛韦（GCV）具有耐药性的巨细胞病毒（CMV）疾病在移植患者中难以控制。Letermovir可能成为治疗和预防gcv耐药巨细胞病毒感染的新选择，但治疗反应的评估是困难的。Letermovir可能通过CYP3A4导致药物相互作用。
Infection with cytomegalovirus (CMV) with resistance to ganciclovir (GCV) is a therapeutic challenge in kidney transplant patients, because standard treatment options are nephrotoxic. We report the case of a kidney transplant recipient with GCV-resistant CMV disease, in whom letermovir, a novel inhibitor of CMV packaging, was administered off-label and prevented a relapse of disease once the CMV load was decreased by cidofovir. Furthermore, we observed significant drug interactions between letermovir and tacrolimus.LEARNING POINTS: Cytomegalovirus (CMV) disease with resistance to ganciclovir (GCV) is difficult to manage in transplant patients.Letermovir may become a new option for treatment and prophylaxis of GCV-resistant CMV infection, but assessment of treatment response is difficult.Letermovir may lead to drug interactions via CYP3A4.