Expanding role of cytomegalovirus as a human pathogen

J Med Virol. 2016 Jul;88(7):1103-12. doi: 10.1002/jmv.24450. Epub 2016 Jan 5.

Abstract

Cytomegalovirus (CMV) continues to be a leading cause of morbidity and mortality in transplant recipients, despite major advancements in preventative strategies. Antiviral prophylaxis and pre-emptive antiviral therapeutic regimens are associated with a high incidence of late-onset end-organ disease and cause drug-related toxicity when overused. Therefore, the identification of risk factors for CMV replication is required. Genetic and immunological factors that predispose individuals to CMV-related clinical complications have been identified and may be instrumental for optimizing CMV treatment in the future. Evidence suggests a causal pathogenetic link between CMV-related complications and inflammatory diseases in non-canonically immunosuppressed individuals such as patients with lung injury and critically ill and cancer patients. However, a randomized clinical trial is required to determine if a causal relationship exists.

Keywords: T-cell immunity; critically ill patients; cytomegalovirus; glioblastoma multiforme; host genetics; transplant recipients.

Publication types

  • Review

MeSH terms

  • Acyclovir / adverse effects
  • Acyclovir / therapeutic use
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / drug effects
  • Cytomegalovirus / genetics
  • Cytomegalovirus / pathogenicity*
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology*
  • Ganciclovir / adverse effects
  • Ganciclovir / therapeutic use
  • Humans
  • Immunocompromised Host
  • Risk Factors
  • Transplant Recipients

Substances

  • Antiviral Agents
  • Ganciclovir
  • Acyclovir