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Vulvovaginal Candidiasis — SCE Infectious Diseases MCQ

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HardSTIsVulvovaginal CandidiasisSCE Infectious Diseases

A kidney-transplant recipient has CMV DNAaemia that rises despite correctly dosed valganciclovir and then foscarnet. Genotyping and adherence review support refractory infection; severe renal impairment limits further foscarnet. Which NICE-approved option is most relevant?

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Correct answer: B — Maribavir for refractory post-transplant CMV under specialist management

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

D is correct. NICE TA860 recommends maribavir within its marketing authorisation for adults after solid-organ or haematopoietic stem-cell transplant whose CMV is refractory to standard agents including ganciclovir/valganciclovir, cidofovir or foscarnet. The oral route and lack of foscarnet-like nephrotoxicity are clinically useful, although resistance, interactions and viral-load response require specialist monitoring. Letermovir is principally prophylactic, aciclovir lacks adequate CMV activity, and ribavirin is not established CMV treatment.

Reference: NICE TA860: maribavir for refractory CMV after transplant: https://www.nice.org.uk/guidance/ta860/chapter/1-Recommendations