{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:45:34Z","timestamp":1792154734037,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:00:00Z","timestamp":1606867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Treatment of ganciclovir\u2010resistant (GCV\u2010R)\/refractory cytomegalovirus (CMV) infections in blood\/marrow transplant (BMT) and solid organ transplant (SOT) recipients remains suboptimal. Cidofovir (CDV), a nucleotide analogue with anti\u2010CMV activity, is nephrotoxic and oculotoxic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively evaluated the outcomes of SOT and BMT patients with GCV\u2010R\/refractory CMV treated with CDV between 1\/1\/2008 and 12\/31\/2017. Data collected: baseline demographics, CMV serostatus, clinical and virologic presentations and outcomes, UL97 and UL54 genotype mutations, drug toxicities, and cause of death. Descriptive statistics were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>16 patients received CDV for treatment of CMV: six BMT and 10 SOT. Seven (47%) of the patients had high\u2010risk donor\/recipient serostatus: six (60%) SOT were D+\/R\u2010; one (16.7%) BMT was D\u2212\/R+. Median time to CMV DNAemia was 131\u00a0days post\u2010transplant (IQR, 37.5\u2010230.3). Proven tissue invasive disease was present in three patients (18.8%). Twelve (75%) had genotype testing; 10 (83.3%) of those had antiviral resistance mutations. While on CDV, six (37.5%) developed nephrotoxicity, and four (25%) developed uveitis (two had both uveitis and nephrotoxicity). Eight (50%) had failure to clear CMV DNAemia despite CDV treatment. Eight (50%) of the patients died; median time to death, after initiation of CDV, was 33.5\u00a0days [IQR22\u2010988].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the absence of good therapeutic alternatives, CDV is used in GCV\u2010R\/refractory CMV infection. However, it is associated with a substantial risk of toxicity and failure to clear CMV DNAemia, highlighting the need for development of newer and less toxic therapies. The high mortality in this group of patients underscores the severity of illness in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.13521","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T13:16:05Z","timestamp":1605964565000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Outcomes of transplant recipients treated with cidofovir for resistant or refractory cytomegalovirus infection"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-7922","authenticated-orcid":false,"given":"Seema A.","family":"Mehta Steinke","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins Baltimore MD USA"},{"name":"Pueblo Infectious Diseases, PLLC Pueblo CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Alfares","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Valsamakis","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology Department of Pathology Johns Hopkins Baltimore MD USA"},{"name":"Roche Molecular Diagnostics Pleasanton CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shmuel","family":"Shoham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravit","family":"Arav\u2010Boger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Johns Hopkins Baltimore MD USA"},{"name":"Children's Hospital of Wisconsin Milwaukee WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lees","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darin","family":"Ostrander","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Forman","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology Department of Pathology Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audra","family":"Shedeck","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard F.","family":"Ambinder","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard John","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7692-3619","authenticated-orcid":false,"given":"Robin K.","family":"Avery","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine Johns Hopkins Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001418"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix259"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3062.2002.t01-1-02008.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/342385"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02607-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy696"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1999.89"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2015.266"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703251"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.2.388"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2005.02.009"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00721-11"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00009-10"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000170"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199652020-00006"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(07)70159-7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706640"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2018.11.005"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0860-8"},{"key":"e_1_2_9_22_1","article-title":"Letermovir 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