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

European journal of case reports in internal medicine

Authors: Uta S Koepf, Hans U Klehr, Anna-M Eis-Huebinger, Souhaib Aldabbagh, Christian P Strassburg, Dominik Boes, Philipp Lutz

UNLABELLED: 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.

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.

© EFIM 2020.

PMID: 32665929

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