Antiviral drug resistance in cytomegalovirus complicating hematopoietic stem cell transplantation: prevalence, genotypic analysis and novel UL97/UL54 variants

Çevik Ş., GÖKAHMETOĞLU S., PARKAN Ö. M., KAYNAR L., KARAKÜKCÜ M., Kabirun M.

Journal of Chemotherapy, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1080/1120009x.2026.2643053
  • Dergi Adı: Journal of Chemotherapy
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE
  • Anahtar Kelimeler: antiviral agents, Cytomegalovirus, drug resistance, hematopoietic stem cell transplantation, UL54, UL97
  • Erciyes Üniversitesi Adresli: Evet

Özet

This study investigated antiviral resistance by sequencing UL97 and UL54 in cytomegalovirus (CMV) strains from haematology and hematopoietic stem cell transplant (HSCT) patients. Fifty-one samples from 48 patients (21 paediatric and 27 adult) with CMV DNA ≥1000 IU/mL and persistent viremia despite therapy were analysed. Resistance-associated mutations were identified in 6/48 patients (12.5%), all HSCT recipients–three paediatric and three adults. Detected mutations included UL97 (A591V, E596G and C603W), combined UL97 (M460I and C592G) and UL54 (F412L) mutations, and a UL54 (L957F) mutation. Additionally, 28 patients harboured 11 previously reported variants not associated with resistance. Novel UL97 (n = 18) and UL54 (n = 20) variants were also identified. In conclusion, prevalence of CMV antiviral resistance was 14.2% in CMV-infected HSCT recipients, slightly higher in paediatric patients. Detection of known and novel UL97/UL54 mutations highlights the importance of monitoring and the need for studies to assess the clinical impact of novel variants.