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耐药巨细胞病毒感染占器官移植后人群的5％～10％。巨细胞病毒UL97、UL54或两者共同突变是巨细胞病毒耐药的主要机制。巨细胞病毒耐药的危险因素主要有:巨细胞病毒阴性受者接受巨细胞病毒血清阳性供者的器官(D+/R-),口服及长期(>3个月)更昔洛韦治疗,高病毒含量。对耐药巨细胞病毒株的检测常用的试验方法有表型的方法和基因的方法。对于耐药巨细胞病毒疾病的治疗方法包括对应用免疫抑制剂者降低其剂量,应用巨细胞病毒免疫球蛋白,加大更昔洛韦治疗剂量或换用其他抗病毒药物治疗。本文从巨细胞病毒耐药性出现、定义、机制、危险因素及治疗作了综述。
Resistant cytomegalovirus infections account for 5% -10% of the population after organ transplantation. Cytomegalovirus UL97, UL54 or both co-mutation is the main mechanism of cytomegalovirus resistance. The main risk factors for cytomegalovirus resistance are: cytomegalovirus negative recipients receiving cytomegalovirus seropositive donor organs (D + / R-), oral and long-term (> 3 months) treatment with ganciclovir, high Virus content. Test methods commonly used for the detection of resistant cytomegalovirus strains include phenotypic and genetic methods. For the treatment of drug resistant cytomegalovirus disease, including the use of immunosuppressants to reduce its dose, the application of cytomegalovirus immunoglobulin, ganciclovir treatment dose increase or switch to other antiviral drugs. This article reviewed the definition, mechanism, risk factors and treatment of cytomegalovirus resistance.