TY - JOUR
T1 - Cytomegalovirus infection in transplant recipients
T2 - newly approved additions to our armamentarium
AU - Khawaja, Fareed
AU - Spallone, Amy
AU - Kotton, Camille N.
AU - Chemaly, Roy F.
N1 - Funding Information:
Medical writing support was provided only for the development of the outline of this article by Amy Holloway of Caudex, Oxford, UK, and was funded by Takeda Pharmaceuticals Inc., Lexington, MA. All the authors participated in developing the content of this article without any external medical writing support.
Funding Information:
We thank Ashli Nguyen-Villarreal, Associate Scientific Editor, and Sarah Bronson, Scientific Editor in the Research Medical Library at the University of Texas MD Anderson Cancer Center, for editing this manuscript. Shailesh Desai and Daniele Gelone from Takeda Pharmaceuticals, Inc. Lexington, MA reviewed the manuscript for scientific accuracy.
Publisher Copyright:
© 2022 The Authors
PY - 2023/1
Y1 - 2023/1
N2 - Background: The burden that cytomegalovirus (CMV) portends for haematopoietic and solid-organ transplant recipients cannot be understated. Valganciclovir and ganciclovir have successfully been used for prevention and treatment of CMV infections, although with serious side effects such as leucopenia and some development of resistance. Until recently, available therapies for ganciclovir-resistant CMV have significant toxicities. Although advances have been made in the field, the unmet medical needs for effective and well-tolerated therapies are significant. Objectives: This review aims to summarise the current and emerging CMV antiviral drugs and discusses future perspectives in the field. Sources: We searched for relevant articles with pertinent keywords: “Cytomegalovirus OR CMV”, “Transplant” and “Antiviral”. Articles published after 2019 were given preference. Articles were reviewed by the authors for relevance and impact to the subject of interest. Content: We outline in this review current advances in prophylaxis of CMV infection with letermovir, breakthrough CMV infections while on or after prophylaxis, the development of resistant and refractory CMV infections, and the newly approved anti-CMV agent, maribavir, in haematopoietic and solid-organ transplant recipients. Implications: Prevention of CMV infections after transplant has improved greatly over the past few years. Despite major advancements, breakthrough CMV infections and development of refractory and resistant CMV infections remain major complications post transplantation. We highlight emerging therapeutics that tolerably and effectively prevent and treat CMV infections, especially refractory and resistant cases.
AB - Background: The burden that cytomegalovirus (CMV) portends for haematopoietic and solid-organ transplant recipients cannot be understated. Valganciclovir and ganciclovir have successfully been used for prevention and treatment of CMV infections, although with serious side effects such as leucopenia and some development of resistance. Until recently, available therapies for ganciclovir-resistant CMV have significant toxicities. Although advances have been made in the field, the unmet medical needs for effective and well-tolerated therapies are significant. Objectives: This review aims to summarise the current and emerging CMV antiviral drugs and discusses future perspectives in the field. Sources: We searched for relevant articles with pertinent keywords: “Cytomegalovirus OR CMV”, “Transplant” and “Antiviral”. Articles published after 2019 were given preference. Articles were reviewed by the authors for relevance and impact to the subject of interest. Content: We outline in this review current advances in prophylaxis of CMV infection with letermovir, breakthrough CMV infections while on or after prophylaxis, the development of resistant and refractory CMV infections, and the newly approved anti-CMV agent, maribavir, in haematopoietic and solid-organ transplant recipients. Implications: Prevention of CMV infections after transplant has improved greatly over the past few years. Despite major advancements, breakthrough CMV infections and development of refractory and resistant CMV infections remain major complications post transplantation. We highlight emerging therapeutics that tolerably and effectively prevent and treat CMV infections, especially refractory and resistant cases.
KW - Anti-CMV therapy
KW - Cytomegalovirus
KW - Hematopoietic cell transplant
KW - Letermovir
KW - Maribavir
KW - Solid organ transplant
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U2 - 10.1016/j.cmi.2022.07.001
DO - 10.1016/j.cmi.2022.07.001
M3 - Review article
C2 - 35843567
AN - SCOPUS:85138569491
SN - 1198-743X
VL - 29
SP - 44
EP - 50
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 1
ER -