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Both patients achieved CMV DNA clearance within 30 and 18 days; however, the UL97 C480F variant emerged, causing recurrent CMV infection after a cumulative 2 months of MBV and 15 or 4 weeks of ganciclovir treatment, respectively. C480F was not detected under ganciclovir before MBV treatment. Recombinant phenotyping showed that C480F conferred the highest level of MBV resistance and ganciclovir cross-resistance, with impaired viral growth. Clinical follow-up and genotypic and phenotypic studies are essential for the assessment and optimization of patients with suspected MBV resistance.<\/jats:p>","DOI":"10.1093\/infdis\/jiab029","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T20:14:17Z","timestamp":1610741657000},"page":"1024-1028","source":"Crossref","is-referenced-by-count":17,"title":["Phenotype and Genotype Study of Novel C480F Maribavir-Ganciclovir Cross-Resistance Mutation Detected in Hematopoietic Stem Cell and Solid Organ Transplant Recipients"],"prefix":"10.1093","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5270-4454","authenticated-orcid":false,"given":"Marta","family":"Santos Bravo","sequence":"first","affiliation":[{"name":"Microbiology Department, Hospital Clinic I Provincial de Barcelona, Institut of Global Health of Barcelona (ISGlobal), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Plault","sequence":"additional","affiliation":[{"name":"National Reference Center for Cytomegaloviruses, Microbiology Department, Centre Hospitalier Universitaire Limoges, Institut national de la sant\u00e9 et de la recherche m\u00e9dicale 1092, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonsoles","family":"S\u00e1nchez Palomino","sequence":"additional","affiliation":[{"name":"AIDS Research Group, Institut D\u2019Investigacions Biom\u00e8diques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Mar","family":"Mosquera Gutierrez","sequence":"additional","affiliation":[{"name":"Microbiology Department, Hospital Clinic I Provincial de Barcelona, Institut of Global Health of Barcelona (ISGlobal), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Fern\u00e1ndez Avil\u00e9s","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Unit, Hematology Department, Hospital Cl\u00ednic i Provincial, Institut D\u2019Investigacions Biom\u00e8diques August Pi I Sunyer, Institut Josep Carreras, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Suarez Lledo","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplant Unit, Hematology Department, Hospital Cl\u00ednic i Provincial, Institut D\u2019Investigacions Biom\u00e8diques August Pi I Sunyer, Institut Josep Carreras, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Sab\u00e9 Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Bellvitge University Hospital, Insitut D\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge, 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