Mutations in human cytymegalovirus (Orthoherpesviridae: Herpesvirales: Cytomegalovirus: Cytomegalovirus humanbeta 5) UL97 gene lead to increase in viremia duration and poor antiviral response in recipients of allogeneic hematopoietic stem cells.

Q3 Medicine Voprosy virusologii Pub Date : 2024-11-09 DOI:10.36233/0507-4088-251
D S Tikhomirov, M V Demin, A A Serikova, B V Biderman, A B Sudarikov, F P Filatov, T A Tupoleva
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Abstract

Introduction: Human cytomegalovirus (Orthoherpesviridae: Herpesvirales: Cytomegalovirus: Cytomegalovirus humanbeta 5) (HCMV) is one of the most commonly detected viruses in recipients of allogeneic hematopoietic stem cell (allo-HSCT) transplants. However, the emergence of resistance to antiviral drugs such as ganciclovir (GCV) poses a challenge in managing these patients. This study aims to investigate the prevalence and impact of mutations in the HCMV UL97 gene associated with resistance to GCV on the course of infection among allo-HSCT patients.

Materials and methods: The study examined the association between UL97 mutations and the clinical course of HCMV infection in allo-HSCT patients. Genetic sequencing was performed to identify mutations, and their impact on viral replication and resistance to GCV was assessed.

Results and discussion: Six mutations were identified (D490A, T502A, C592G, C592F, E596G, C603W). C592G, C592F, E596G, and C603W are associated with resistance to antiviral drugs, while D490A and T502A described for the first time. When comparing patients with wild-type and those carrying the mutant variant, several parameters of peripheral blood were significantly lower in the former group. The median time to peak viral load following allo-HSCT, duration of viremia, and rate of virological response to high-dose therapy also differed significantly between the two groups.

Conclusion: It was shown that approximately one third (4 out of 14) of allogeneic stem cell transplant recipients had mutations associated with resistance to GCV. Patients carrying the mutant variant of HCMV had longer viremia and took longer to achieve a negative virological test result after starting high-dose therapy. Performing genotyping may help make more evidence-based therapeutic decisions.

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人类巨细胞病毒(疱疹病毒科:疱疹病毒属:巨细胞病毒:人巨细胞病毒β5)UL97 基因突变会导致异体造血干细胞受体的病毒血症持续时间延长和抗病毒反应减弱。
导言:人类巨细胞病毒(疱疹病毒科:疱疹病毒属:巨细胞病毒:人类巨细胞病毒(Cytomegalovirus humanbeta 5)(HCMV)是异基因造血干细胞(allo-HSCT)移植受者中最常检测到的病毒之一。然而,更昔洛韦(GCV)等抗病毒药物耐药性的出现给这些患者的治疗带来了挑战。本研究旨在调查与 GCV 耐药性相关的 HCMV UL97 基因突变的发生率及其对异体 HSCT 患者感染过程的影响:该研究考察了异体 HSCT 患者中 UL97 基因突变与 HCMV 感染临床过程之间的关联。通过基因测序确定突变,并评估其对病毒复制和 GCV 耐药性的影响:结果与讨论:共发现六种基因突变(D490A、T502A、C592G、C592F、E596G、C603W)。C592G、C592F、E596G和C603W与抗病毒药物耐药性有关,而D490A和T502A则是首次描述。比较野生型患者和携带突变变体的患者,前者外周血的几项参数明显较低。两组患者在异体造血干细胞移植后达到病毒载量峰值的中位时间、病毒血症持续时间和对大剂量治疗的病毒学应答率也有显著差异:结论:研究表明,约三分之一的异体干细胞移植受者(14人中有4人)存在与GCV耐药性相关的突变。携带 HCMV 突变变体的患者病毒血症时间更长,开始大剂量治疗后病毒学检测结果为阴性的时间也更长。进行基因分型有助于做出更多循证治疗决策。
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来源期刊
Voprosy virusologii
Voprosy virusologii Medicine-Infectious Diseases
CiteScore
2.00
自引率
0.00%
发文量
48
期刊介绍: The journal deals with advances in virology in Russia and abroad. It publishes papers dealing with investigations of viral diseases of man, animals and plants, the results of experimental research on different problems of general and special virology. The journal publishes materials are which promote introduction into practice of the achievements of the virological science in the eradication and incidence reduction of infectious diseases, as well as their diagnosis, treatment and prevention. The reader will find a description of new methods of investigation, new apparatus and devices.
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