Mutations conferring ganciclovir resistance in a cohort of patients with acquired immunodeficiency syndrome and cytomegalovirus retinitis

Douglas A. Jabs, Barbara K. Martin, Michael S. Forman, J. P. Dunn, Janet L. Davis, David V. Weinberg, Karen K. Biron, Fausto Baldanti

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Cytomegalovirus (CMV) retinitis is among the most common opportunistic infections in patients with acquired immunodeficiency syndrome. In a prospective study of 210 patients with CMV retinitis, 26 were identified as having either a phenotypic or a genotypic ganciclovir-resistant isolate from either blood or urine cultures. For blood culture isolates with an IC50 >6.0 μm for ganciclovir, the sensitivity and specificity for detecting a UL97 mutation were 95% and 98%, respectively, whereas for an IC50 >8.0 μM they were 79% and 99%, respectively. Although there were trade-offs between the 2 thresholds for blood culture isolates, for urine culture isolates an IC50 >8.0 μM appeared to be better at identifying genotypic resistance. UL97 mutations identified in both the blood and urine cultures of individual patients were identical in 87.5% of cases. High-level ganciclovir resistance (IC50, >30 μM) typically, but not invariably, was associated with a mutation in both the UL97 and UL54 genes.

Original languageEnglish (US)
Pages (from-to)333-337
Number of pages5
JournalJournal of Infectious Diseases
Issue number2
StatePublished - Jan 15 2001


ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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