Molecular mechanisms and targets underlying immune evasion by human cytomegalovirus

Human cytomegalovirus (HCMV) establishes lifelong latency in humans largely through the evolution of sophisticated immune evasion strategies that allow it to escape recognition and clearance by the host immune system. While significant progress has been made in elucidating the mechanisms underlying HCMV immune evasion, the precise regulation of host immune responses that enables viral persistence remains incompletely understood. In this review, we provide a comprehensive overview of the current knowledge on HCMV immune evasion, with a particular emphasis on the functions of HCMV-encoded genes. We examine how these gene products impair immune cell responses, inhibit interferon production, reshape the immune microenvironment, and interact synergistically to promote viral latency and long-term persistence. Furthermore, we also explore the potential involvement of HCMV in the pathogenesis of cancer and autoimmune diseases, aiming to bridge molecular mechanisms with clinical implications and provide insights for the prevention and treatment of HCMV and related conditions.