TABLE 4.
Summary of each case evaluated
| Patient Diagnosisa, age (y), gender | CMV serostatusb | Antiviral historyc | CMV End-organ diseased | Transplant to CDV initiation (d)e | Peak CMV viral load (lU/mL) | Genotype | Duration of CDV (d) | CMV DNAemia outcomeh | Toxicity | Clinical outcome | Presumed cause of death |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OHT, 38, M | D+/R− | GCV, VGCV, FOS | Not present | 468 | 107 030 | L595Sf | 18 | Failure | Nephrotoxicity | Alive | – |
| KTx, 67, F | D+/R− | GCV, FOS | Proven colitis | 292 | 2 097 000 | L595Sf | 84 | Cleared | Uveitis | Deceased | CVA |
| BMT, 21, F | D?/R? | GCV, FOS | Not present | 96 | 18 605 | Not done | 19 | Failure | None | Deceased | Disease progression |
| KTx, 59, F | D+/R− | VGCV, GCV | Suspected colitis | 292 | 38 888 | L595Sf | 6 | Cleared | None | Alive | – |
| KTx, 30, F | D+/R+ | VGCV, GCV | Suspected colitis, pneumonitis | 392 | 18 242 969 | Negative for mutations | 12 | Cleared | None | Alive | – |
| LTx, 64, M | D?/R? | VGCV, GCV | Not present | 278 | 624 | Not done | 12 | Cleared | None | Deceased | Sepsis, NOS |
| KTx, 52, M | D+/R+ | VGCV, GCV | Not present | 49 | 12 162 | A594Vf | 29 | Cleared | None | Alive | – |
| LgTx, 65, M | D+/R− | VGCV, GCV | Not present | 203 | 7804 | A594Vf | 27 | Cleared | Uveitis | Alive | – |
| KTx, 70, F | D+/R+ | GCV | Proven colitis | 267 | 8991 | Not done | 21 | Failure | None | Deceased | SDH, CVA |
| BMT, 20, F | D−/R+ | GCV, FOS | Suspected pneumonitis | 61 | 8760 | Negative for mutations | 7 | Cleared | None | Deceased | Disease progression |
| BMT, 24, F | D+/R− | VGCV, GCV, FOS | Not present | 518 | 196 000 | Negative for mutations | 83 | Cleared | Uveitis + Nephrotoxicity | Alive | – |
| OHT, 45, F | D+/R− | GCV, FOS, NFV | Not present | 236 | 116 000 | E596G/Ef, A594A/Pf, A692Sg | 51 | Failure | Uveitis + Nephrotoxicity | Alive | |
| BMT, 22, M | D+/R+ | VGCV | Not present | 446 | 6 100 000 | Not done | 33 | Failure | Nephrotoxicity | Alive | – |
| KTx, 62, M | D+/R− | GCV, FOS, LEF, NFV | Not present | 402 | 314 000 | A594Vf, C603Wf | 13 | Failure | Nephrotoxicity | Alive | – |
| BMT, 26, F | D+/R− | GCV, FOS | Suspected HCd, meningitis, and pneumonitis | 190 | 1410 000 | A809A/Vg | 53 | Failure | Nephrotoxicity | Deceased | Disease progression |
| BMT, 46, M | D−/R− | GCV, FOS | Proven pneumonitis | 142 | 37 700 | C603Wf, G841G/Ag | 26 | Failure | None | Deceased | DAD due to CMV pneumonitis |
Abbreviations: CVA, cerebral vascular accident; DAD, diffuse alveolar damage; disease progression, progression of underlying malignancy; SDH, subdural hematoma.
BMT vs SOT. SOT categories: OHT, orthotopic heart transplant; KTx, kidney transplant; LTx, liver transplant; LgTx, lung transplant.
CMV donor/recipient serostatus.
Antiviral history prior to initiation of cidofovir (CDV): VGCV, valganciclovir; GCV, ganciclovir; FOS, foscarnet; NFV, nelfinavir; LEF, leflunomide.
Addresses if end-organ, tissue invasive disease is present or not, and if present, what organ is involved. HC, hemorrhagic cystitis.
Days between transplant date and initiation of CDV.
UL97 genotype (see Table 2 for resistance conferred by specific mutation).
UL54 genotype (see Table 2 for resistance conferred by specific mutation).
Virologic outcome: Cleared vs failure. Cleared is achieving two undetectable CMV DNA levels at least 5 days apart. Failure is not achieving clearance.