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Current and Future Strategies for the Prevention and Treatment of Cytomegalovirus Infections in Transplantation

Madeleine R Heldman1, Michael J Boeckh2,3,4, Ajit P Limaye5

  • 1Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|November 4, 2024
PubMed

Insights

Preventing and treating cytomegalovirus (CMV) infection is crucial in transplantation. Recent advances focus on risk assessment, antivirals, and enhancing immune responses through vaccines and cell therapies for better patient outcomes.

Area of Science:

  • Immunology
  • Transplantation Medicine
  • Infectious Diseases

Background:

  • Cytomegalovirus (CMV) infection poses significant risks in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT).
  • Effective prevention and treatment strategies are critical for patient survival and graft success.
  • Recent clinical trials have introduced new paradigms in CMV management.

Purpose of the Study:

  • To review recent advances in CMV risk assessment.
  • To summarize progress in antiviral and immune-based strategies for CMV prevention and treatment.
  • To discuss methods for optimizing CMV-specific immunity in transplant recipients.

Main Methods:

  • Review of pivotal clinical trials and observational studies.
  • Analysis of antiviral and immune-based prevention and treatment strategies.
  • Summary of cell-mediated immunity assays for refining CMV management.

Main Results:

  • New paradigms in CMV prevention have emerged, with diverging approaches for HCT and SOT.
  • Advances include improved risk assessment and progress in antiviral therapies.
  • Immune-based strategies like vaccination, monoclonal antibodies, and virus-specific T-cells show promise.

Conclusions:

  • Enhancing CMV-specific immunity is vital to mitigate negative impacts in various transplant settings.
  • Optimizing immune responses is key to improving outcomes for transplant recipients.
  • Further research into CMV management in immunocompromised populations is warranted.
Keywords:
antiviralscytomegalovirus (CMV)preemptive therapytransplantationvirus-specific T-cells

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