The use of sirolimus in ganciclovir‐resistant cytomegalovirus infections in renal transplant recipients
- 3 May 2007
- journal article
- clinical trial
- Published by Wiley in Clinical Transplantation
- Vol. 21 (5), 675-680
- https://doi.org/10.1111/j.1399-0012.2007.00699.x
Abstract
Background: the widespread use of prophylactic ganciclovir and anti-lymphocyte/thymocyte therapies are associated with increased induction of ganciclovir-resistant cytomegalovirus (CMV) strains. the use of sirolimus has been associated with a lower incidence of CMV infection in transplant recipients. We questioned whether it could also be effective as a therapeutic treatment of resistant CMV infection.Methods: Patients with ganciclovir-resistant CMV infections determined clinically and by DNA sequencing analysis were enrolled. Antigenaemia and DNA sequencing were used to diagnosis and follow the mutations.Results: Nine transplant patients were given sirolimus plus mycophenolate mofetil (n = 4) or a calcineurin inhibitor (n = 5). Seven out of nine recipients were CMV IgG negative before transplantation. We observed a rapid decrease in antigenaemia levels, reaching zero in eight out of nine (88.9%) patients within a median of 20.3 +/- 10.1 d. Graft function remained stable and no patient presented acute rejection or recurrence of the CMV infection.Conclusions: This suggests that the use of sirolimus plus ganciclovir therapy could be useful in ganciclovir-resistant CMV infections.Universidade Federal de São Paulo, Disciplina Nefrol, Div Nephrol, Clin & Expt Immunol Lab, BR-04023900 São Paulo, BrazilHosp Rim & Hipertensao, São Paulo, BrazilUniversidade Federal de São Paulo, Lab Immunobiol Transplantes, Dept Immunol, Inst Biomed Sci 4, BR-04023900 São Paulo, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Nefrol, Div Nephrol, Clin & Expt Immunol Lab, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Lab Immunobiol Transplantes, Dept Immunol, Inst Biomed Sci 4, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, BR-04023900 São Paulo, BrazilWeb of SciencKeywords
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