Cytomegalovirus in Solid Organ Transplantation: Epidemiology, Prevention, and Treatment

Overview

Journal Curr Infect Dis Rep

Specialty Infectious Diseases

Date 2012 Sep 21

PMID 22992839

Citations 44

Authors

Elena Beam

Raymund R Razonable

Affiliations

Soon will be listed here.

Abstract

Cytomegalovirus (CMV) is one of the most important pathogens that infect solid organ transplant recipients. CMV is associated with increased morbidity and mortality in this population as a result of its numerous direct and indirect effects. Prevention strategies consist of preemptive therapy and antiviral prophylaxis, and the choice of which preventive approach to implement should be guided by advantages and drawbacks related to the population being managed. There are differences in the approaches to the laboratory diagnosis and treatment of CMV infection and disease depending on assay availability, clinical presentation, disease severity, and specific transplant populations. In this article, the authors aim to summarize recent publications and updates in the epidemiology, diagnosis, prevention, and treatment of CMV infection in solid organ transplant recipients during the past year, including a brief review of future directions in the field.

Citing Articles

Discordance between humoral and cellular immune responses to cytomegalovirus infection in CMV seropositive patients awaiting lung transplantation.

Boada-Perez M, Berastegui C, Erro M, Ussetti P, Crespo E, Donadeu L Front Immunol. 2025; 15:1445553.

PMID: 39911579 PMC: 11794206. DOI: 10.3389/fimmu.2024.1445553.

Pitfalls in Valganciclovir Prophylaxis Dose Adjustment Based on Renal Function in Kidney Transplant Recipients.

Hammer N, Hoessly L, Haidar F, Hirzel C, de Seigneux S, Van Delden C Transpl Int. 2024; 37:12712.

PMID: 38784442 PMC: 11112565. DOI: 10.3389/ti.2024.12712.

Herpes Virus Infection in Lung Transplantation: Diagnosis, Treatment and Prevention Strategies.

Patrucco F, Curtoni A, Sidoti F, Zanotto E, Bondi A, Albera C Viruses. 2023; 15(12).

PMID: 38140567 PMC: 10747259. DOI: 10.3390/v15122326.

Cytomegalovirus Infection in Patient with Clear Cell Renal Cell Carcinoma.

Rinaldi I, Muthalib A, Sutandar J, Kuncoro H, Harsono B, Susanto N Case Rep Med. 2023; 2023:5560673.

PMID: 38023618 PMC: 10661874. DOI: 10.1155/2023/5560673.

Cytomegalovirus Disease as a Risk Factor for Invasive Fungal Infections in Liver Transplant Recipients under Targeted Antiviral and Antimycotic Prophylaxis.

Breitkopf R, Treml B, Bukumiric Z, Innerhofer N, Fodor M, Radovanovic Spurnic A J Clin Med. 2023; 12(16).

PMID: 37629240 PMC: 10455861. DOI: 10.3390/jcm12165198.

References

Boivin G, Goyette N, Farhan M, Ives J, Elston R . Incidence of cytomegalovirus UL97 and UL54 amino acid substitutions detected after 100 or 200 days of valganciclovir prophylaxis. J Clin Virol. 2012; 53(3):208-13. DOI: 10.1016/j.jcv.2011.12.019. View

Hayden R, Yan X, Wick M, Rodriguez A, Xiong X, Ginocchio C . Factors contributing to variability of quantitative viral PCR results in proficiency testing samples: a multivariate analysis. J Clin Microbiol. 2011; 50(2):337-45. PMC: 3264161. DOI: 10.1128/JCM.01287-11. View

Lisboa L, Preiksaitis J, Humar A, Kumar D . Clinical utility of molecular surveillance for cytomegalovirus after antiviral prophylaxis in high-risk solid organ transplant recipients. Transplantation. 2011; 92(9):1063-8. DOI: 10.1097/TP.0b013e31822fa4b7. View

Giulieri S, Manuel O . QuantiFERON®-CMV assay for the assessment of cytomegalovirus cell-mediated immunity. Expert Rev Mol Diagn. 2010; 11(1):17-25. DOI: 10.1586/erm.10.109. View

Boudreault A, Xie H, Rakita R, Scott J, Davis C, Boeckh M . Risk factors for late-onset cytomegalovirus disease in donor seropositive/recipient seronegative kidney transplant recipients who receive antiviral prophylaxis. Transpl Infect Dis. 2011; 13(3):244-9. PMC: 3148074. DOI: 10.1111/j.1399-3062.2011.00624.x. View

Kute V, Vanikar A, Shah P, Gumber M, Patel H, Godara S . Post-renal transplant cytomegalovirus infection: study of risk factors. Transplant Proc. 2012; 44(3):706-9. DOI: 10.1016/j.transproceed.2011.12.025. View

Kalil A, Mindru C, Florescu D . Effectiveness of valganciclovir 900 mg versus 450 mg for cytomegalovirus prophylaxis in transplantation: direct and indirect treatment comparison meta-analysis. Clin Infect Dis. 2010; 52(3):313-21. DOI: 10.1093/cid/ciq143. View

Lurain N, Chou S . Antiviral drug resistance of human cytomegalovirus. Clin Microbiol Rev. 2010; 23(4):689-712. PMC: 2952978. DOI: 10.1128/CMR.00009-10. View

Cordero E, Casasola C, Ecarma R, Danguilan R . Cytomegalovirus disease in kidney transplant recipients: incidence, clinical profile, and risk factors. Transplant Proc. 2012; 44(3):694-700. DOI: 10.1016/j.transproceed.2011.11.053. View

10.

Kharfan-Dabaja M, Boeckh M, Wilck M, Langston A, Chu A, Wloch M . A novel therapeutic cytomegalovirus DNA vaccine in allogeneic haemopoietic stem-cell transplantation: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis. 2012; 12(4):290-9. DOI: 10.1016/S1473-3099(11)70344-9. View

11.

Clari M, Munoz-Cobo B, Solano C, Benet I, Costa E, Remigia M . Performance of the QuantiFERON-cytomegalovirus (CMV) assay for detection and estimation of the magnitude and functionality of the CMV-specific gamma interferon-producing CD8(+) T-cell response in allogeneic stem cell transplant recipients. Clin Vaccine Immunol. 2012; 19(5):791-6. PMC: 3346332. DOI: 10.1128/CVI.05633-11. View

12.

Paya C, Humar A, Dominguez E, Washburn K, Blumberg E, Alexander B . Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant. 2004; 4(4):611-20. DOI: 10.1111/j.1600-6143.2004.00382.x. View

13.

Griffiths P, Stanton A, McCarrell E, Smith C, Osman M, Harber M . Cytomegalovirus glycoprotein-B vaccine with MF59 adjuvant in transplant recipients: a phase 2 randomised placebo-controlled trial. Lancet. 2011; 377(9773):1256-63. PMC: 3075549. DOI: 10.1016/S0140-6736(11)60136-0. View

14.

Linares L, Sanclemente G, Cervera C, Hoyo I, Cofan F, Ricart M . Influence of cytomegalovirus disease in outcome of solid organ transplant patients. Transplant Proc. 2011; 43(6):2145-8. DOI: 10.1016/j.transproceed.2011.05.007. View

15.

Kaul D, Stoelben S, Cober E, Ojo T, Sandusky E, Lischka P . First report of successful treatment of multidrug-resistant cytomegalovirus disease with the novel anti-CMV compound AIC246. Am J Transplant. 2011; 11(5):1079-84. DOI: 10.1111/j.1600-6143.2011.03530.x. View

16.

Snydman D, Limaye A, Potena L, Zamora M . Update and review: state-of-the-art management of cytomegalovirus infection and disease following thoracic organ transplantation. Transplant Proc. 2011; 43(3 Suppl):S1-S17. DOI: 10.1016/j.transproceed.2011.02.069. View

17.

Bosch W, Heckman M, Diehl N, Shalev J, Pungpapong S, Hellinger W . Association of cytomegalovirus infection and disease with death and graft loss after liver transplant in high-risk recipients. Am J Transplant. 2011; 11(10):2181-9. DOI: 10.1111/j.1600-6143.2011.03618.x. View

18.

Wiita A, Roubinian N, Khan Y, Chin-Hong P, Singer J, Golden J . Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis. Transpl Infect Dis. 2012; 14(3):248-58. DOI: 10.1111/j.1399-3062.2012.00723.x. View

19.

Asberg A, Humar A, Rollag H, Jardine A, Mouas H, Pescovitz M . Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant. 2007; 7(9):2106-13. DOI: 10.1111/j.1600-6143.2007.01910.x. View

20.

Kang S, Abdel-Massih R, Brown R, Dierkhising R, Kremers W, Razonable R . Homozygosity for the toll-like receptor 2 R753Q single-nucleotide polymorphism is a risk factor for cytomegalovirus disease after liver transplantation. J Infect Dis. 2012; 205(4):639-46. PMC: 3266129. DOI: 10.1093/infdis/jir819. View