Ogawa Lauren, Morinishi Chelsea, Multani Ashrit, Gaynor Pryce, Beaird Omer E, Pham Christine, Schaenman Joanna M
Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Department of Pharmacy, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Viruses. 2024 Dec 7;16(12):1889. doi: 10.3390/v16121889.
Cytomegalovirus (CMV) infection in solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients may increase the risk of rejection or allograft dysfunction, other infection(s), and morbidity and mortality. Treatment can be challenging due to medication-associated toxicities. Maribavir (MBV) is a promising option for the treatment of resistant or refractory (R/R) CMV infection in lieu of foscarnet (FOS), which has long been the recommended therapy for (val)ganciclovir-resistant infection. This was a single-center retrospective study of clinical outcomes of patients who received MBV compared to a control group who received FOS for an episode of CMV infection. Each cohort consisted of 27 episodes of CMV infection. Twenty patients in the MBV cohort and from the FOS cohort cleared the infection, with five and three patients developing MBV or FOS resistance, respectively. There were no statistically significant differences in failure of therapy as evidenced by persistent DNAemia ( = 0.56) or development of antiviral resistance ( = 0.24). In conclusion, MBV was as effective as FOS for the treatment of R/R CMV infection and was better tolerated without increased risk of antiviral resistance.
实体器官移植（SOT）受者和造血细胞移植（HCT）受者的巨细胞病毒（CMV）感染可能会增加排斥反应或移植物功能障碍、其他感染以及发病和死亡的风险。由于药物相关毒性，治疗可能具有挑战性。马里巴韦（MBV）是治疗耐药或难治性（R/R）CMV感染的一个有前景的选择，可替代膦甲酸钠（FOS），长期以来膦甲酸钠一直是治疗（缬）更昔洛韦耐药感染的推荐疗法。这是一项单中心回顾性研究，比较了接受MBV治疗的患者与接受FOS治疗CMV感染发作的对照组的临床结局。每个队列包括27例CMV感染发作。MBV队列和FOS队列中分别有20例患者清除了感染，分别有5例和3例患者出现MBV或FOS耐药。在治疗失败方面，持续性病毒血症（P=0.56）或抗病毒耐药的发生（P=0.24）均无统计学显著差异。总之，MBV在治疗R/R CMV感染方面与FOS一样有效，耐受性更好，且抗病毒耐药风险未增加。
