Advances in the treatment of cytomegalovirus

Human cytomegalovirus (HCMV) is a threat to immunologically weak patients. HCMV cannot yet be eliminated with a vaccine, despite recent advances. Sources of data are recently published research papers and reviews about HCMV treatments. Current antivirals target the UL54 DNA polymerase and are limite...

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Bibliographic Details
Published in:British medical bulletin 2019-09, Vol.131 (1), p.5-17
Main Authors: Krishna, B A, Wills, M R, Sinclair, J H
Format: Article
Language:English
Subjects:
Antiviral Agents - pharmacology
Antiviral Agents - therapeutic use
Cytomegalovirus - physiology
Cytomegalovirus Infections - congenital
Cytomegalovirus Infections - immunology
Cytomegalovirus Infections - prevention & control
Cytomegalovirus Vaccines
Drug Development
Early Diagnosis
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Immunity, Cellular - physiology
Immunoglobulins - therapeutic use
Immunosuppression - adverse effects
Infant, Newborn
Invited Review
Organ Transplantation - adverse effects
Perinatal Care
Virus Latency - drug effects
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Summary:Human cytomegalovirus (HCMV) is a threat to immunologically weak patients. HCMV cannot yet be eliminated with a vaccine, despite recent advances. Sources of data are recently published research papers and reviews about HCMV treatments. Current antivirals target the UL54 DNA polymerase and are limited by nephrotoxicity and viral resistance. Promisingly, letermovir targets the HCMV terminase complex and has been recently approved by the FDA and EMA. Should we screen newborns for HCMV, and use antivirals to treat sensorineural hearing loss after congenital HCMV infection? Growing points are developing drugs against latently infected cells. In addition to small molecule inhibitors, a chemokine-based fusion toxin protein, F49A-FTP, has shown promise in killing both lytically and latently infected cells. We need to understand what immune responses are required to control HCMV, and how best to raise these immune responses with a vaccine.
ISSN:0007-1420
1471-8391
DOI:10.1093/bmb/ldz031