Pyrosequencing allows the detection of emergent ganciclovir resistance mutations after HCMV infection
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Prenatally acquired human cytomegalovirus (HCMV) infection is the most frequent viral infection of newborns in developed countries. Virostatic therapy is accompanied by side effects and stepwise emergence of resistant virus variants. Different genotypic approaches show limited sensitivity in detecting on-growing minor resistant virus populations. Here, we demonstrate the superiority of pyrosequencing for the monitoring of mutant emergence. In a preterm baby born after 28 weeks of gestation and suffering from disseminated congenital HCMV infection, long-term control could not be achieved under ganciclovir/valganciclovir therapy and the infant died on the 113th day of life. Resistance-associated mutations in the HCMV UL97 gene were not detected by conventional DNA sequencing but postmortem pyrosequencing. Four different CMV variants carrying resistance-associated mutations each representing 11–17% of the total CMV population were found.
KeywordsHCMV infection Resistance-associated mutations Pyrosequencing
The authors wish to thank Dr. M. Raftery (Institute of Medical Virology Charité, Berlin) for critical reading of the manuscript. Expert technical assistance by Mrs. C. Stephan, S. Liebmann, and C. Walter is gratefully acknowledged.
Conflict of interest
The authors have declared that no conflict of interests exist.
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