Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 1;34(6):663-671.
doi: 10.1097/QCO.0000000000000797.

Cytomegalovirus in primary immunodeficiency

Jack Godsell  1 , Samantha Chan  1   2   3 , Charlotte Slade  1   2 , Vanessa Bryant  1   2 , Jo Anne Douglass  1   3 , Joe Sasadeusz  4 , Michelle K Yong  4   5   6
Affiliations
Review

Cytomegalovirus in primary immunodeficiency

Jack Godsell et al. Curr Opin Infect Dis. .

Abstract

Purpose of review: Cytomegalovirus (CMV) infection and disease are well described in the setting of secondary immunodeficiency. Less is known about CMV in the context of primary immunodeficiencies (PIDs), where inborn errors in one or more arms of the immune system result in variable degrees of CMV susceptibility.

Recent findings: PID presents unique challenges in the diagnosis and management of CMV disease. The clinical presentation of CMV in PID is often severe, accelerated by underlying immune dysregulation and iatrogenic immunosuppression. Here we describe the clinical significance of CMV infection in PID, the key components of immune defence against CMV and how these are affected in specific PIDs. CMV disease is under-recognized as a complication of common variable immunodeficiency (CVID). High rates of CMV end-organ disease, mortality, development of CMV resistance and prolonged antiviral use have been observed in individuals with CVID.

Summary: We recommend that clinicians tailor their approach to the individual based on their underlying immune deficit and maintain a high index of suspicion and low threshold for treatment. More research is required to improve stratification of CMV risk in PID, develop new diagnostic tools and manage end-organ disease in this cohort.

PubMed Disclaimer

References

    1. Bousfiha AA, Jeddane L, Ailal F, et al. Primary immunodeficiency diseases worldwide: more common than generally thought. J Clin Immunol 2013; 33:1–7.
    1. Abolhassani H, Azizi G, Sharifi L, et al. Global systematic review of primary immunodeficiency registries. Expert Rev Clin Immunol 2020; 16:717–732.
    1. Bousfiha A, Jeddane L, Picard C, et al. Human inborn errors of immunity: 2019 update of the IUIS phenotypical classification. J Clin Immunol 2020; 40:66–81.
    1. Jeffrey Modell Foundation 10 Warning Signs of Primary Immunodeficiency for Adults. 2009. http://www.info4pi.org/aboutPI/pdf/Adult10WarningSignsFINAL.pdf . [Accessed 10 July 2021].
    1. Seale H, MacIntyre CR, Gidding HF, et al. National serosurvey of cytomegalovirus in Australia. Clin Vaccine Immunol 2006; 13:1181–1184.

MeSH terms

Substances