Prospects for the clinical management of human cytomegalovirus infections

Infection of susceptible populations by human cytomegalovirus (HCMV) is a significant public health problem in Western societies. Vaccination with live attenuated strains of HCMV has demonstrated some degree of clinical benefit but objections based on the possibility of these viruses becoming latent and their potential oncogenicity must be considered. Our knowledge of the biology and immunology of HCMV, although advancing rapidly, is still a long way short of being able to predict candidate subunit vaccines based on virus encoded proteins or glycoproteins. Treatment of the disease by injection of antibodies awaits a breakthrough and chemicals effective in the control of other human herpes viruses are disappointingly ineffective against HCMV. Clearly, prophylaxis is preferable to therapy and it is in the design of new effective vaccines that endeavours must be channelled so that we can control complications associated with severe clinical infection with this virus.