Why CMV is a candidate for elimination and then eradication

Area of Science:

• Virology
• Immunology
• Public Health

Background:

• Cytomegalovirus (CMV) is a common virus known to cause significant end-organ diseases (EODs) in immunocompromised individuals.
• These direct effects, such as in transplant recipients or those with advanced HIV, are well-documented.
• Emerging evidence suggests broader, indirect impacts of CMV across various populations.

Purpose of the Study:

• To review the direct and indirect effects of Cytomegalovirus (CMV) across diverse patient populations.
• To evaluate the global health burden attributed to CMV, considering both direct and indirect consequences.
• To explore the potential of vaccines in mitigating the indirect effects of CMV and enhancing cost-effectiveness.

Main Methods:

• Systematic review of existing literature on Cytomegalovirus (CMV).
• Analysis of studies detailing direct effects (EODs) in congenital infection, solid organ transplantation, bone marrow transplantation, and advanced HIV.
• Examination of evidence linking CMV to indirect effects in intensive care units, the elderly, and the general population.

Main Results:

• Cytomegalovirus (CMV) causes significant direct end-organ diseases (EODs) in immunocompromised hosts.
• Indirect effects of CMV are observed across a wide range of populations, including transplant recipients, critically ill patients, the elderly, and the general population.
• The study proposes that the greatest global burden of CMV stems from these widespread indirect effects.

Conclusions:

• The indirect effects of Cytomegalovirus (CMV) likely represent the largest global health burden associated with this virus.
• Current vaccine development focuses on preventing EODs, but vaccines may also offer substantial benefits against indirect CMV effects.
• Universal CMV immunization could be financially advantageous due to its potential to reduce both direct and indirect disease burdens.