A case of ganciclovir-resistant cytomegalovirus (CMV) retinitis in a patient with AIDS: longitudinal molecular analysis of the CMV viral load and viral mutations in blood …
G Boivin, C Gilbert, M Morissette, J Handfield… - Aids, 1997 - journals.lww.com
G Boivin, C Gilbert, M Morissette, J Handfield, N Goyette, MG Bergeron
Aids, 1997•journals.lww.comObjectives: 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 …
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 …
Abstract
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 (V 594) 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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