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The significant clinical impact of HCMV infection and progression to HCMV disease among allogeneic hematopoietic stem cell transplant recipients has been reduced by prophylactic, preemptive, and curative treatments using ganciclovir, valganciclovir, foscarnet, and cidofovir. Resistance to (val)ganciclovir results from mutations localized in HCMV <jats:italic>UL97<\/jats:italic> gene (encoding the pUL97 phosphotransferase), <jats:italic>UL54<\/jats:italic> gene (encoding the pUL54 DNA polymerase), or both genes, whereas foscarnet and cidofovir resistance results from mutations localized within <jats:italic>UL54<\/jats:italic> gene only. This review is focused on HCMV antiviral drug resistance, including the functions of target genes of antivirals, the mechanisms of antiviral resistance, the different mutations in pUL97 and pUL54 that have been identified in either clinical isolates or laboratory strains, and their impact on HCMV susceptibility to antiviral drugs. It emphasizes the importance of proving that observed genetic changes confer resistance so they can be distinguished from polymorphisms. Because of the emergence of HCMV resistance to currently available drugs, novel drugs are urgently needed for the therapeutic management of HCMV\u2010resistant infections in hematopoietic stem cell transplant patients. Copyright \u00a9 2016 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/rmv.1873","type":"journal-article","created":{"date-parts":[[2016,3,18]],"date-time":"2016-03-18T13:46:36Z","timestamp":1458308796000},"page":"161-182","source":"Crossref","is-referenced-by-count":67,"title":["Human cytomegalovirus antiviral drug resistance in hematopoietic stem cell transplantation: current state of the art"],"prefix":"10.1002","volume":"26","author":[{"given":"Ana Bela","family":"Campos","sequence":"first","affiliation":[{"name":"Molecular Oncology and Viral Pathology Group (CI\u2010IPOP)  Porto Portugal"},{"name":"Faculty of Medicine University of Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Molecular Oncology and Viral Pathology Group (CI\u2010IPOP)  Porto Portugal"},{"name":"Virology Service Portuguese Oncology Institute of Porto  Porto Portugal"},{"name":"Faculty of 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