New Insights on CMV Management in Solid Organ Transplant Patients: Prevention, Treatment, and Management of Resistant/Refractory Disease

Cytomegalovirus (CMV) infection can have both direct and indirect effects after solid-organ transplantation, with a significant impact on transplant outcomes. Prevention strategies decrease the risk of CMV disease, although CMV still occurs in up to 50% of high-risk patients. Ganciclovir (GCV) and v...

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Bibliographic Details
Published in:Infectious diseases and therapy 2023-02, Vol.12 (2), p.333-342
Main Authors: Kotton, Camille Nelson, Kamar, Nassim
Format: Article
Language:English
Subjects:
Acids
Bacterial infections
Care and treatment
Cytomegalovirus
Cytomegalovirus infections
Disease prevention
Health aspects
Hospital costs
Infection
Infections
Infectious Diseases
Internal Medicine
Kidney transplants
Letermovir
Leukopenia
Liver
Maribavir
Medicine
Medicine & Public Health
Mortality
Neutropenia
Organ transplantation
Polyclonal antibodies
Prevention
Refractory CMV
Resistant CMV
Review
Serology
Side effects
Toxicity
Transplantation of organs, tissues, etc
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Summary:Cytomegalovirus (CMV) infection can have both direct and indirect effects after solid-organ transplantation, with a significant impact on transplant outcomes. Prevention strategies decrease the risk of CMV disease, although CMV still occurs in up to 50% of high-risk patients. Ganciclovir (GCV) and valganciclovir (VGCV) are the main drugs currently used for preventing and treating CMV. Emerging data suggest that letermovir is as effective as VGCV with fewer hematological side effects. Refractory and resistant CMV also still occur in solid-organ-transplant patients. Maribavir has been shown to be effective and have less toxicity in the treatment of refractory and resistant CMV. In this review paper, we discuss prevention strategies, refractory and resistant CMV, and drug-related side effects and their impact, as well as optimal use of novel anti-CMV therapies.
ISSN:2193-8229
2193-6382
DOI:10.1007/s40121-022-00746-1