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Topic: CMV Antiviral Resistance | 2016-06-11 | |
Difficulty: Moderate |
Author: | Chris Doern |
Question Type: Multiple Possible Answers Please Select ALL Correct Answers |
A 45 year old male who has recently undergone a CMV donor positive, recipient negative kidney transplant has a CMV viral load come back as 400,000 copies/ml. He has been on prophylactic doses of valganciclovir to prevent the emergence of CMV disease with routine monitoring of his CMV viral loads. Prior to receiving this most recent value his loads were the following…
1. Initial 5,000 copies/ml
2. 7 days later: 15,000 copies/ml
3. 7 days later: 40,000 copies/ml
At this point he was admitted and switched from prophylactic valganciclovir to treatment doses of ganciclovir. Initially his viral loads decreased, however after a month of therapy his loads began to increase again and eventually reached 400,000 copies/ml.
You decide you want to look for mutations that would confer resistance to ganciclovir. What two genes do you need to sequence?
1. Initial 5,000 copies/ml
2. 7 days later: 15,000 copies/ml
3. 7 days later: 40,000 copies/ml
At this point he was admitted and switched from prophylactic valganciclovir to treatment doses of ganciclovir. Initially his viral loads decreased, however after a month of therapy his loads began to increase again and eventually reached 400,000 copies/ml.
You decide you want to look for mutations that would confer resistance to ganciclovir. What two genes do you need to sequence?