Among the 7 most common UL97 mutations encountered in ganciclovir-resistant clinical cytomegalovirus isolates, the associated cyclopropavir cross-resistance varies from insignificant (L595S) to substantial (M460I and H520Q) as determined by recombinant phenotyping. Mutations M460I and H520Q were preferentially selected in vitro under cyclopropavir and conferred 12-to 20-fold increases in 50% effective concentration (EC 50 ) values, while M460V, C592G, A594V, and C603W conferred 3-to 5-fold increases. Uncommon mutations M460T and C603R increased cyclopropavir EC 50 s by 8-to 10-fold.As a major opportunistic pathogen in immunosuppressed individuals, especially transplant recipients, human cytomegalovirus (CMV) infection often requires prolonged antiviral prophylaxis or treatment (9). Because the currently marketed drugs ganciclovir (GCV) (or its oral prodrug valganciclovir), foscarnet, and cidofovir can be limited by issues of tolerability and cross-resistance (10), there are ongoing efforts to develop new antiviral options. Several Z-isomer methylenecyclopropane nucleoside analogs have shown potent in vitro anti-CMV activity (12), particularly the compound cyclopropavir (CPV) (or ZSM-I-62, 5b [11]), which had low cytotoxicity (8) and showed in vivo efficacy in an immunodeficient mouse model of human CMV infection (7). CPV is an attractive candidate for clinical trials.Similarly to GCV, initial phosphorylation by the viral UL97 kinase is required for the antiviral action of CPV (6). Wellcharacterized (canonical) mutations in UL97 are found in GCV-resistant clinical strains, with one of the seven mutations M460V/I, H520Q, C592G, A594V, L595S, and C603W encountered in close to 90% of cases (10). Other UL97 mutations confer various degrees of GCV resistance, while mutations in the UL54 DNA polymerase gene sometimes evolve to increase