Update on cytomegalovirus in transplant recipients: new agents, prophylaxis, and cell-mediated immunity

Purpose of review This review is an overview of recent advances in diagnostics, therapies, and prevention strategies for cytomegalovirus (CMV), focusing on solid-organ transplant and hematopoietic stem cell transplant recipients. Recent findings A randomized trial of prophylaxis vs preemptive therapy in donor-seropositive, recipient-seronegative liver transplant recipients found significantly less CMV disease in the preemptive group. Maribavir has shown promise for the treatment of resistant/refractory CMV and for uncomplicated CMV DNAemia. A post hoc mortality analysis, as well as emerging reports of real-world and off-label use, have expanded the spectrum of clinical experience with letermovir. The first interventional trials using CMV cell-mediated immune assays have been published and showed promising results for delineating antiviral strategies. New data from additional interventional trials are expected soon. Summary The past 1–2 years have seen major developments in the area of CMV management in transplant recipients. Expanding diagnostic and therapeutic capabilities provide a foundation for optimizing strategies in the future, to reduce morbidity and mortality from CMV.
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: INFECTIONS OF THE IMMUNOCOMPROMISED HOST: Edited by Genovefa A. Papanicolaou and Dionysios Neofytos Source Type: research