What is the impact of resistant CMV infection on transplant recipients and other immunosuppressed patients?

Transplantation is a life-saving procedure for patients with end-stage organ disease, but requires immunosuppressive medications to prevent rejection. This increases risk and severity of infections that don’t normally affect healthy individuals, which contribute significantly to morbidity and mortality. One of the most common and significant of these is cytomegalovirus (CMV) which causes clinical disease and indirect effects such as rejection, secondary infections and decreased survival. Highly effective antivirals are available, but a small subgroup of patients do not respond well to these, developing antiviral resistance and often treatment failure. Second line agents are limited, difficult to access and have increased toxicities, leading to poor outcomes. This clinical research project aims to define the incidence and burden of resistant CMV infection in patients at Alfred Health. All patients who have had resistance testing performed will be included, describing the mutations identified, comorbidities, and CMV disease course. Patients with confirmed resistance mutations will be compared to those without, examining risk factors and outcomes including duration of hospitalization and survival. Clinical data collection from electronic medical records will be part of the project, which will also involve statistical analyses and other clinical research methodologies but no laboratory work. Previous experience using R is desirable but not essential. This study will set the groundwork for future research aimed at preventing resistance occurring. This project will be located within the infectious diseases department at Alfred Health and supervised by Dr Bradley Gardiner & Professor Anton Peleg.