Cargando…

Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus

Cytomegalovirus (CMV) infection remains a major cause of morbidity, graft failure, and death in kidney transplant recipients. We describe a case of a 53-year-old CMV-seronegative man who underwent renal transplant from a CMV-positive donor and who developed ganciclovir- (GCV-) resistant CMV infectio...

Descripción completa

Detalles Bibliográficos
Autores principales: Menghi, Viola, Comai, Giorgia, Baraldi, Olga, Liviano D'Arcangelo, Giovanni, Lazzarotto, Tiziana, La Manna, Gaetano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752979/
https://www.ncbi.nlm.nih.gov/pubmed/26942027
http://dx.doi.org/10.1155/2016/2736805
_version_ 1782415810790162432
author Menghi, Viola
Comai, Giorgia
Baraldi, Olga
Liviano D'Arcangelo, Giovanni
Lazzarotto, Tiziana
La Manna, Gaetano
author_facet Menghi, Viola
Comai, Giorgia
Baraldi, Olga
Liviano D'Arcangelo, Giovanni
Lazzarotto, Tiziana
La Manna, Gaetano
author_sort Menghi, Viola
collection PubMed
description Cytomegalovirus (CMV) infection remains a major cause of morbidity, graft failure, and death in kidney transplant recipients. We describe a case of a 53-year-old CMV-seronegative man who underwent renal transplant from a CMV-positive donor and who developed ganciclovir- (GCV-) resistant CMV infection. Foscarnet was started while immunosuppressive therapy was modified with the introduction of everolimus minimizing tacrolimus dosage. Only two weeks after the start of this treatment regimen was the patient's viral load negative. At two-year follow-up the patient has no clinical or laboratory signs of CMV infection and a good and stable renal function or graft survival. In our case, administration of an mTOR inhibitor combined with foscarnet led to rapid and persistent viral clearance without compromising short- and medium-term graft function. This combination therapy supports the need for the kidney transplant community to individualize a target therapy for each type of GCV-resistant CMV infection.
format Online
Article
Text
id pubmed-4752979
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Hindawi Publishing Corporation
record_format MEDLINE/PubMed
spelling pubmed-47529792016-03-03 Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus Menghi, Viola Comai, Giorgia Baraldi, Olga Liviano D'Arcangelo, Giovanni Lazzarotto, Tiziana La Manna, Gaetano Case Rep Nephrol Case Report Cytomegalovirus (CMV) infection remains a major cause of morbidity, graft failure, and death in kidney transplant recipients. We describe a case of a 53-year-old CMV-seronegative man who underwent renal transplant from a CMV-positive donor and who developed ganciclovir- (GCV-) resistant CMV infection. Foscarnet was started while immunosuppressive therapy was modified with the introduction of everolimus minimizing tacrolimus dosage. Only two weeks after the start of this treatment regimen was the patient's viral load negative. At two-year follow-up the patient has no clinical or laboratory signs of CMV infection and a good and stable renal function or graft survival. In our case, administration of an mTOR inhibitor combined with foscarnet led to rapid and persistent viral clearance without compromising short- and medium-term graft function. This combination therapy supports the need for the kidney transplant community to individualize a target therapy for each type of GCV-resistant CMV infection. Hindawi Publishing Corporation 2016 2016-01-31 /pmc/articles/PMC4752979/ /pubmed/26942027 http://dx.doi.org/10.1155/2016/2736805 Text en Copyright © 2016 Viola Menghi et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Menghi, Viola
Comai, Giorgia
Baraldi, Olga
Liviano D'Arcangelo, Giovanni
Lazzarotto, Tiziana
La Manna, Gaetano
Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title_full Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title_fullStr Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title_full_unstemmed Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title_short Ganciclovir-Resistant Cytomegalovirus Infection in a Kidney Transplant Recipient Successfully Treated with Foscarnet and Everolimus
title_sort ganciclovir-resistant cytomegalovirus infection in a kidney transplant recipient successfully treated with foscarnet and everolimus
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752979/
https://www.ncbi.nlm.nih.gov/pubmed/26942027
http://dx.doi.org/10.1155/2016/2736805
work_keys_str_mv AT menghiviola ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus
AT comaigiorgia ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus
AT baraldiolga ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus
AT livianodarcangelogiovanni ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus
AT lazzarottotiziana ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus
AT lamannagaetano ganciclovirresistantcytomegalovirusinfectioninakidneytransplantrecipientsuccessfullytreatedwithfoscarnetandeverolimus