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Transpl Infect Dis ; 15(6): E243-9, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24298985

ABSTRACT

Treatment of cytomegalovirus (CMV) disease in transplant patients is challenging and, with antiviral resistance to first-line drugs, it remains uncertain which treatment algorithm to follow. Some data suggest that leflunomide, a pyrimidine synthesis inhibitor, can be used to treat resistant CMV infections. We report a 57-year-old CMV immunoglobulin-G (IgG)-seronegative woman, who received a bilateral lung transplant (LuTx) from a CMV IgG-positive donor with CMV primary disease. The CMV strain was genotypically resistant to ganciclovir, foscarnet, and cidofovir. After starting leflunomide as add-on therapy to a multidrug anti-CMV regimen, viral load declined substantially in 2 months without adverse events. This experience is discussed against the background of existing literature on the use of leflunomide as an anti-CMV agent in LuTx recipients.


Subject(s)
Antiviral Agents/therapeutic use , Cytomegalovirus Infections/drug therapy , Isoxazoles/therapeutic use , Lung Transplantation/adverse effects , Cytomegalovirus/drug effects , Cytomegalovirus Infections/transmission , Drug Resistance, Viral , Drug Therapy, Combination , Female , Foscarnet/therapeutic use , Ganciclovir/therapeutic use , Humans , Immunoglobulins/therapeutic use , Leflunomide , Middle Aged , Viral Load
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