Multiple ganciclovir-resistant strains in a newborn with symptomatic congenital human cytomegalovirus infection

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Abstract

A case of human cytomegalovirus (HCMV) drug-resistance in a congenitally infected newborn is described. Unusual aspects of this case include: (i) the detection of an extremely complex virus population, composed of a mixture of wild-type (wt) and multiple mutant ganciclovir (GCV) and valganciclovir (val-GCV) resistant strains carrying a variety of known mutations in UL97; (ii) the identification of novel UL97 mutations and (iii) the first time detection of combined UL97 drug resistance mutations in the same viral strain. In detail, four known UL97 single-nucleotide mutations (A594T/V, M460V/I, C592G), a new amino-acid substitution (C607S), and a new deletion (597-600) in one of the three UL97 hot spots for GCV/val-GCV resistance (codons 460, 520 and 590-607) were detected. In addition, the combination of M460V. +. A594V and M460V. +. C592G was observed for the first time. The emergence of HCMV drug-resistance in symptomatic congenital infections chronically treated with GCV or val-GCV should be taken into account. The immaturity of the neonatal immune system may contribute to selection of complex virus populations in these patients.

Original languageEnglish
Pages (from-to)86-88
Number of pages3
JournalJournal of Clinical Virology
Volume54
Issue number1
DOIs
Publication statusPublished - May 2012

Keywords

  • Congenital
  • Ganciclovir
  • HCMV mutations
  • Resistance

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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