Smith I L, Shinkai M, Freeman W R, Spector S A
Department of Pediatrics, University of California, San Diego, La Jolla 92093-0672, USA.
J Infect Dis. 1996 Jun;173(6):1481-4. doi: 10.1093/infdis/173.6.1481.
To investigate the role of antiviral drug resistance in cytomegalovirus (CMV) disease progression, CMV cultured from an AIDS patient who developed progressive CMV disease despite continual anti- CMV treatment was characterized. In 7 CMV isolates, 1 ganciclovir-resistant strain predominated. Ganciclovir-resistant CMV, containing a UL97 mutation, was cultured from blood and urine before clinical indication of CMV central nervous system (CNS) disease, suggesting that the development of ganciclovir resistance preceded the dissemination of CMV to the CNS. Quantitative competitive polymerase chain reaction indicated that the isolation of ganciclovir-resistant CMV was concurrent with increased CMV DNA in plasma. The results suggest that antiviral resistance should be considered when selecting therapy for CMV CNS disease that develops in patients receiving treatment for CMV retinitis. In addition, plasma CMV DNA in AIDS patients receiving anti-CMV therapy may be a useful marker of disease progression and antiviral resistance.
为了研究抗病毒药物耐药性在巨细胞病毒（CMV）疾病进展中的作用，对一名尽管持续接受抗CMV治疗仍发生进行性CMV疾病的艾滋病患者所培养的CMV进行了特征分析。在7株CMV分离株中，1株耐更昔洛韦菌株占主导。从血液和尿液中培养出含有UL97突变的耐更昔洛韦CMV，此时CMV中枢神经系统（CNS）疾病尚无临床指征，这表明更昔洛韦耐药性的出现先于CMV向CNS的播散。定量竞争性聚合酶链反应表明，耐更昔洛韦CMV的分离与血浆中CMV DNA的增加同时发生。结果表明，在为接受CMV视网膜炎治疗的患者中发生的CMV CNS疾病选择治疗方法时，应考虑抗病毒耐药性。此外，接受抗CMV治疗的艾滋病患者的血浆CMV DNA可能是疾病进展和抗病毒耐药性的有用标志物。
Zotero 插件