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Is HCMV vaccine an unmet need? The state of art of vaccine development
Insights
Congenital human cytomegalovirus (HCMV) infection is common and can cause severe infant health issues. This review explores various HCMV vaccine types and strategies for future implementation.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Congenital human cytomegalovirus (HCMV) infection affects 0.2-2.5% of live births, making it the most common congenital infection.
- Approximately 11% of infected newborns exhibit symptoms like organomegaly, thrombocytopenia, and neurological or sensory deficits at birth.
- A significant percentage (5-25%) of asymptomatic neonates develop long-term sequelae, highlighting the need for effective prevention.
Discussion:
- The substantial social and economic burden associated with congenital HCMV infection necessitates the development of preventative measures.
- Current research has explored diverse vaccine platforms, including live attenuated, subunit, vectored, peptide, DNA, and subviral vaccines.
- Despite extensive research, no HCMV vaccine is currently available for clinical use.
Key Insights:
- Review of various HCMV vaccine candidates and their developmental status.
- Analysis of potential vaccination strategies, including target populations and implementation approaches.
- Emphasis on the critical need for a safe and effective HCMV vaccine to mitigate disease burden.
Outlook:
- Future research should focus on advancing promising vaccine candidates towards clinical trials.
- Development of targeted vaccination strategies for pregnant women or newborns is crucial.
- Successful HCMV vaccine deployment could significantly reduce the incidence and long-term consequences of congenital infection.
Abstract:
Congenital HCMV infection is the most frequent congenital infection, with an incidence of 0.2- 2.5 percent among all live births. About 11 percent of infected newborns show symptoms at birth, including hepato-splenomegaly, thrombocytopenia, neurologic involvement, hearing impairment and visual deficit. Moreover, 5-25 percent of the asymptomatic congenital HCMV-infected neonates will develop sequelae over months or even years. The relevant social burden, the economic costs of pre-natal screening, post-natal diagnosis, follow-up and possible therapy, although still limited, are the major factors to be considered. Several types of vaccines have been explored in order to develop an effective and safe HCMV vaccine: live attenuated, subunit, vectored, peptide, DNA, and subviral ones, but none are available for use. This review illustrates the different vaccine types studied to date, focusing on the possible vaccination strategy to be implemented once the HCMV vaccine is available, in terms of target population.
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