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Cytomegalovirus vaccines under clinical development
1Department of Pediatrics , University of Minnesota Medical School , Minneapolis , MN , USA.
Insights
Cytomegalovirus (CMV) infection is a leading cause of infant disability and poses risks to transplant recipients. Developing a CMV vaccine is crucial for public health, with promising candidates currently under investigation.
Area of Science:
- Virology
- Immunology
- Vaccinology
Background:
- Congenital cytomegalovirus (CMV) infection is the most common infectious cause of disability in newborns.
- CMV infection also causes significant disease in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients.
- Asymptomatic CMV infections may be linked to long-term health risks like atherosclerosis and cancer, though these associations require further research.
Discussion:
- No licensed CMV vaccines are currently available, but significant interest exists in developing and testing new candidates.
- A recombinant CMV glycoprotein B (gB) vaccine has shown some efficacy in preventing infection in young women, adolescents, and CMV-seronegative SOT recipients.
- This review examines the current status of candidate CMV vaccines and evolving concepts regarding correlates of protective immunity.
Key Insights:
- A vaccine for congenital CMV infection offers the greatest public health impact and cost-effectiveness.
- All populations could potentially benefit from effective CMV immunization.
- Research is actively exploring vaccine candidates and understanding immune responses.
Outlook:
- Continued development and testing of CMV vaccine candidates are essential.
- Understanding correlates of protection is critical for designing effective clinical trials.
- Future CMV vaccines aim to prevent congenital infections and disease in vulnerable populations.
Abstract:
Congenital cytomegalovirus (CMV) infection is the most common infectious cause of disability in newborn infants. CMV also causes serious disease in solid organ (SOT) and haematopoietic stem cell transplant (HSCT) recipients. In otherwise healthy children and adults, primary CMV infection rarely causes illness. However, even asymptomatic CMV infections may predispose an individual towards an increased risk of atherosclerosis, cancer and immune senescence over the life course, although such associations remain controversial. Thus, although a vaccine against congenital CMV infection would have the greatest public health impact and cost-effectiveness, arguably all populations could benefit from an effective immunisation against this virus. Currently there are no licensed CMV vaccines, but there is increased interest in developing and testing potential candidates, driven by the demonstration that a recombinant CMV glycoprotein B (gB) vaccine has some efficacy in prevention of infection in young women and adolescents, and in CMV-seronegative SOT recipients. In this review, the recent and current status of candidate CMV vaccines is discussed. Evolving concepts about proposed correlates of protective immunity in different target populations for CMV vaccination, and how these differences impact current clinical trials, are also reviewed.
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