Cytomegalovirus infection in transplant recipients: newly approved additions to our armamentarium.
Anti-CMV therapy
Cytomegalovirus
Hematopoietic cell transplant
Letermovir
Maribavir
Solid organ transplant
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
11
04
2022
revised:
01
07
2022
accepted:
02
07
2022
pubmed:
18
7
2022
medline:
28
12
2022
entrez:
17
7
2022
Statut:
ppublish
Résumé
The burden that cytomegalovirus (CMV) portends for haematopoietic and solid-organ transplant recipients cannot be understated. Valganciclovir and ganciclovir have successfully been used for prevention and treatment of CMV infections, although with serious side effects such as leucopenia and some development of resistance. Until recently, available therapies for ganciclovir-resistant CMV have significant toxicities. Although advances have been made in the field, the unmet medical needs for effective and well-tolerated therapies are significant. This review aims to summarise the current and emerging CMV antiviral drugs and discusses future perspectives in the field. We searched for relevant articles with pertinent keywords: "Cytomegalovirus OR CMV", "Transplant" and "Antiviral". Articles published after 2019 were given preference. Articles were reviewed by the authors for relevance and impact to the subject of interest. We outline in this review current advances in prophylaxis of CMV infection with letermovir, breakthrough CMV infections while on or after prophylaxis, the development of resistant and refractory CMV infections, and the newly approved anti-CMV agent, maribavir, in haematopoietic and solid-organ transplant recipients. Prevention of CMV infections after transplant has improved greatly over the past few years. Despite major advancements, breakthrough CMV infections and development of refractory and resistant CMV infections remain major complications post transplantation. We highlight emerging therapeutics that tolerably and effectively prevent and treat CMV infections, especially refractory and resistant cases.
Sections du résumé
BACKGROUND
BACKGROUND
The burden that cytomegalovirus (CMV) portends for haematopoietic and solid-organ transplant recipients cannot be understated. Valganciclovir and ganciclovir have successfully been used for prevention and treatment of CMV infections, although with serious side effects such as leucopenia and some development of resistance. Until recently, available therapies for ganciclovir-resistant CMV have significant toxicities. Although advances have been made in the field, the unmet medical needs for effective and well-tolerated therapies are significant.
OBJECTIVES
OBJECTIVE
This review aims to summarise the current and emerging CMV antiviral drugs and discusses future perspectives in the field.
SOURCES
METHODS
We searched for relevant articles with pertinent keywords: "Cytomegalovirus OR CMV", "Transplant" and "Antiviral". Articles published after 2019 were given preference. Articles were reviewed by the authors for relevance and impact to the subject of interest.
CONTENT
BACKGROUND
We outline in this review current advances in prophylaxis of CMV infection with letermovir, breakthrough CMV infections while on or after prophylaxis, the development of resistant and refractory CMV infections, and the newly approved anti-CMV agent, maribavir, in haematopoietic and solid-organ transplant recipients.
IMPLICATIONS
CONCLUSIONS
Prevention of CMV infections after transplant has improved greatly over the past few years. Despite major advancements, breakthrough CMV infections and development of refractory and resistant CMV infections remain major complications post transplantation. We highlight emerging therapeutics that tolerably and effectively prevent and treat CMV infections, especially refractory and resistant cases.
Identifiants
pubmed: 35843567
pii: S1198-743X(22)00348-2
doi: 10.1016/j.cmi.2022.07.001
pii:
doi:
Substances chimiques
Antiviral Agents
0
Ganciclovir
P9G3CKZ4P5
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
44-50Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.