Posttransfusion cytomegalovirus infections

Area of Science:

• Transfusion Medicine
• Infectious Diseases
• Virology

Background:

• Historical studies (1960s-1970s) indicated high cytomegalovirus (CMV) infection rates (16-67%) in transfused immunocompetent patients.
• More recent studies (1980s) show a significant decrease in CMV infection rates (1%) in seronegative patients, with minimal associated morbidity or mortality.
• Transfusion-transmitted CMV infections remain a critical concern for immunocompromised populations, including premature infants and bone marrow transplant recipients, leading to severe illness and death.

Purpose of the Study:

• To review the incidence and impact of transfusion-transmitted cytomegalovirus (CMV) infections.
• To identify high-risk patient groups for transfusion-transmitted CMV.
• To outline strategies for reducing the risk of transfusion-transmitted CMV.

Main Methods:

• Review of prospective studies on transfusion-transmitted cytomegalovirus (CMV) infections.
• Analysis of infection rates in different patient populations over time.
• Evaluation of risk reduction strategies.

Main Results:

• Transfusion-transmitted CMV infection rates in immunocompetent patients have dramatically decreased from 16-67% to 1%.
• Significant morbidity and mortality are associated with transfusion-transmitted CMV in immunocompromised infants and bone marrow transplant recipients.
• Blood transfusion is a less significant risk factor for CMV in solid organ transplant recipients.

Conclusions:

• While CMV infection risk has decreased in immunocompetent individuals, it remains a serious threat to specific immunocompromised groups.
• Providing CMV-seronegative blood products or using frozen, deglycerolized red blood cells can reduce transfusion-transmitted CMV risk.
• Leukocyte removal and CMV immune globulin prophylaxis are effective measures to mitigate post-transfusion CMV infections.