Current review of cytomegalovirus in renal transplantation

Cytomegalovirus (CMV) continues to be a common cause of morbidity and mortality in transplant recipients. It has shifted from being overtly to insidiously lethal. Even with effective prophylactic and preemptive treatment strategies it is the most concerning viral agent in transplant recipients. CMV disease has been associated with the two most common causes of late graft loss; cardiovascular disease and chronic rejection. The incidence and morbidity of CMV infection and disease is probably a reflection of immunosuppressive strategies, and ability to diagnose and monitor for CMV. New molecular tests have been developed which include the antigenernia assay, the hybrid capture assay, RNA detection by nucleic acid sequence based amplification (NASBA), and DNA PCR. New insights have also been reported in the diagnostic, monitoring and treatment of the emergent problem of resistance. Nevertheless, the Holy Grail of CMV is in the development of an effective vaccination against this serious viral pathogen.