{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:07:45Z","timestamp":1793740065721,"version":"4.6.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merck Sharp & Dohme LLC"},{"DOI":"10.13039\/100004334","name":"Merck & Co, Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In a phase 3 trial, letermovir was noninferior to valganciclovir for cytomegalovirus (CMV) disease prophylaxis in kidney transplant recipients who were CMV-seronegative and received kidneys from donors who were CMV-seropositive. Genotypic antiviral resistance and CMV glycoprotein B (gB) genotype are reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Plasma samples with detectable CMV DNA were sequenced for the presence of known letermovir and valganciclovir resistance-associated amino acid substitutions (RASs) encoded by CMV gene regions (UL51, UL54, UL56, UL89, UL97) and prevalence of gB (UL55) genotypes (gB1\u2013gB5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among participants, 84 of 292 (letermovir) and 93 of 297 (valganciclovir) had evaluable data for \u22651 gene target. Letermovir RASs were not detected in participants who received letermovir prophylaxis; however, 3 had valganciclovir RASs (pUL97). Twelve participants who received valganciclovir prophylaxis had valganciclovir RASs (pUL54, pUL97), and 1 who did not receive letermovir during the trial had letermovir RASs (pUL56). All but 1 participant responded to valganciclovir treatment irrespective of breakthrough CMV DNAemia or frequency of RASs. gB1 was the most frequent genotype across all participants and subgroups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Letermovir RASs were not detected with letermovir prophylaxis, supporting a low risk for development of resistance in kidney transplant recipients who were CMV-seronegative and received kidneys from donors who were CMV-seropositive.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov, NCT03443869; EudraCT, 2017-001055-30.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiae287","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T07:41:11Z","timestamp":1718005271000},"page":"e1287-e1298","source":"Crossref","is-referenced-by-count":9,"title":["Cytomegalovirus Antiviral Resistance Among Kidney Transplant Recipients in a Phase 3 Trial of Letermovir vs Valganciclovir Prophylaxis"],"prefix":"10.1093","volume":"230","author":[{"given":"Julie M","family":"Strizki","sequence":"first","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy L","family":"Diamond","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie L","family":"Teal","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwen","family":"Wang","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Stauffer","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A","family":"Haber","sequence":"additional","affiliation":[{"name":"Merck Research Laboratories, Merck & Co., Inc. , Rahway, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"2024121523502977200_jiae287-B1","volume-title":"Valcyte (valganciclovir). 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