Prevention and treatment of cytomegalovirus infection

Although a rare cause of symptomatic infection in normal persons, cytomegalovirus (CMV) is of increasing importance in the immunocompromised host. Effective treatment is now available with ganciclovir; foscarnet offers a possible alternative, especially for patients infected with ganciclovir-resistant CMV strains. Primary CMV infection can be prevented by serologic screening of blood (and organ) donors. An alternative approach for prevention of transfusion-associated CMV infection is leukocyte depletion by filtration. Immunoglobulin immunoprophylaxis remains controversial but may be effective in ameliorating disease in renal allograft patients. Acyclovir is partially effective in suppressing infection in already seropositive patients, but ganciclovir and foscarnet offer more promise for this purpose.