Suppression of CMV Infection with Letermovir in a Kidney Transplant Patient.

Authors :: Koepf US
Klehr HU
Eis-Huebinger AM
Aldabbagh S
Strassburg CP
Boes D
Lutz P
Source :: European journal of case reports in internal medicine [Eur J Case Rep Intern Med] 2020 Apr 20; Vol. 7 (7), pp. 001622. Date of Electronic Publication: 2020 Apr 20 (Print Publication: 2020).
Publication Year :: 2020
Abstract: Infection with cytomegalovirus (CMV) with resistance to ganciclovir (GCV) is a therapeutic challenge in kidney transplant patients, because standard treatment options are nephrotoxic. We report the case of a kidney transplant recipient with GCV-resistant CMV disease, in whom letermovir, a novel inhibitor of CMV packaging, was administered off-label and prevented a relapse of disease once the CMV load was decreased by cidofovir. Furthermore, we observed significant drug interactions between letermovir and tacrolimus.<br />Learning Points: Cytomegalovirus (CMV) disease with resistance to ganciclovir (GCV) is difficult to manage in transplant patients.Letermovir may become a new option for treatment and prophylaxis of GCV-resistant CMV infection, but assessment of treatment response is difficult.Letermovir may lead to drug interactions via CYP3A4.<br />Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests.<br /> (© EFIM 2020.)