Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, Virginia.
Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, Virginia.
Transplant Proc. 2021 May;53(4):1284-1287. doi: 10.1016/j.transproceed.2021.02.001. Epub 2021 Mar 11.
Letermovir is an antiviral agent indicated for primary prophylaxis of cytomegalovirus (CMV) infection and disease in adult allogeneic hematopoietic stem cell transplant recipients. In this case, UL97 mutation that conferred resistance to ganciclovir was seen in a patient 8 months after renal transplant. We report the off-label use of letermovir with adjunct hyperimmune CMV immunoglobulin in the successful treatment of CMV disease. This report is the first to use this combination for treatment of CMV infection with a high viral load. It contributes to the limited available literature supporting the use of letermovir in the treatment of resistant CMV, where current therapeutic options can be suboptimal due to adverse effects and the risk of cross-resistance.
来特莫韦是一种抗病毒药物，适用于成人异基因造血干细胞移植受者巨细胞病毒（CMV）感染和疾病的原发性预防。在本例中，一名肾移植 8 个月后的患者出现了对更昔洛韦耐药的 UL97 突变。我们报告了来特莫韦联合高免疫 CMV 免疫球蛋白用于成功治疗 CMV 疾病的标签外使用。本报告首次使用该联合方案治疗高病毒载量的 CMV 感染。它为有限的现有文献提供了支持，证明来特莫韦可用于治疗耐药性 CMV，由于不良反应和交叉耐药的风险，目前的治疗选择可能并不理想。
