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Tackling Treatment-Refractory and Drug-Resistant CMV in the Solid Organ Transplant Setting: A Care Team Forum®

  1. A 60-year-old heart transplant patient develops severe CMV colitis. His CMV DNAemia (viral load) is 680,000 IU/mL.
    According to current CMV guidelines, which of the following is the preferred initial CMV treatment for this patient?
  2. Which laboratory test should be ordered routinely to monitor for side effects of foscarnet?
    Viral nucleic acid amplification test
    Liver function test
    Serum creatinine
    Thyroid function test
  3. A viral UL97 kinase mutation at site L595S confers what level of resistance to ganciclovir?
    High-level resistance
    Low-level resistance
    Insignificant resistance
    No resistance
  4. A 52-year-old lung transplant patient with renal insufficiency has increasing CMV viral load after 3 weeks of adequately dosed valganciclovir. Genotypic testing reveals a UL97 mutation at site A594V.
    Based on the patient’s history and testing results, which of the following is an appropriate therapeutic choice?
    High-dose ganciclovir