A case of ganciclovir‐resistant cytomegalovirus (CMV) retinitis in a patient with AIDSlongitudinal molecular analysis of the CMV viral load and viral mutations in blood compartments
作者:
Guy Boivin,
Christian Gilbert,
Michel Morissette,
Julie Handfield,
Nathalie Goyette,
Michel Bergeron,
期刊:
AIDS
(OVID Available online 1997)
卷期:
Volume 11,
issue 7
页码: 867-873
ISSN:0269-9370
年代: 1997
出版商: OVID
关键词: Cytomegalovirus;resistance;viral load;ganciclovir;AIDS
数据来源: OVID
摘要:
Objectives:To study the temporal relationships between cytomegalovirus (CMV) viral load and specific UL97 mutations in polymorphonuclear leukocytes (PMNL) and plasma samples from a patient with AIDS who developed ganciclovir-resistant CMV retinitis.Methods:Sequential PMNL and plasma samples were analysed for determination of the CMV viral load using non-molecular methods and a quantitative polymerase chain reaction (PCR) assay. Screening of the same samples for the most common mutations conferring ganciclovir resistance was performed using nested PCR and restriction enzyme analysis.Results:At the time of progression of CMV retinitis (after 6 months of ganciclovir), a rapid increase in the CMV DNA load was found in both PMNL and plasma samples. This increase paralleled the emergence of a specific mutation (V594) in the same samples and recovery of ganciclovir-resistant blood isolates. In this patient, however, the only tests that substantially predicted the progression of CMV disease were the quantitative PCR assay using PMNL and to a lesser extent the pp65 antigenemia assay.Conclusions:Quantitative evaluation of the CMV viral load in PMNL using sensitive assays such as PCR appears to be a promising approach for monitoring antiviral therapy in subjects with AIDS. In addition, common mutations conferring ganciclovir resistance can be detected directly in PMNL and plasma samples.
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