5PSQ-131 Letermovir, ganciclovir and immunoglobulins combination treatment in an immunocompromised patient with cytomegalovirus infection: a case report

Abstract

Cidofovir ILIs were prepared by diluting a vial of cidofovir 375 mg in 60 ml of 0.9% sodium chloride, obtaining a final concentration of 6.25 mg/ml. Of these 60 ml, 5 syringes of 12 ml were loaded (75 mg of cidofovir in each one), which have a stability of 5 months refrigerated (2-8°C), according previous studies.Intralesional cidofovir treatment started in February 2022. After three drug administrations, a significant improvement in lesions was described by a reduction in both their volume and extension. A bad odor of superficial exudate was also reported, which was solved with first polymyxin and later fusidic acid, both administered topically, twice a day. The patient presented good tolerance to injections, only requiring local anesthesia with lidocaine for pain. Conclusion and RelevanceThis is the first case of use of this formulation of cidofovir ILIs in a patient with anogenital condylomatosis and immune deficiency. Previously, it was used in other manifestations of HPV infection. The formulation also proved to be stable, well-tolerated, and easy to prepare. Therefore, this therapy may be considered a reasonable option for the treatment of HVP condylomatosis when other treatments seem ineffective.