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Review
. 2024 Apr 1;29(2):131-137.
doi: 10.1097/MOT.0000000000001139. Epub 2024 Jan 30.

Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Paolo Antonio Grossi  1 , Maddalena Peghin
Affiliations
Review

Recent advances in cytomegalovirus infection management in solid organ transplant recipients

Paolo Antonio Grossi et al. Curr Opin Organ Transplant. .

Abstract

Purpose of review: Human cytomegalovirus (CMV) continues to be the most important infectious complication following solid organ transplantation (SOT).

Recent findings: Universal prophylaxis and preemptive therapy are the most adopted strategies for prevention of CMV disease globally. Prophylaxis with valganciclovir is the most widely used approach to CMV prevention, however leukopenia and late onset CMV disease after discontinuation of prophylaxis requires new strategies to prevent this complication. The use of assays detecting CMV-specific T cell-mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. Letermovir has been recently approved for prophylaxis in kidney transplant recipients. CMV-RNAemia used together with CMV-DNAemia in the viral surveillance of CMV infection provides accurate information on viral load kinetics, mostly in patients receiving letermovir prophylaxis/therapy. The development of refractory and resistant CMV infection remains a major challenge and a new treatment with maribavir is currently available. In the present paper we will review the most recent advances in prevention and treatment of CMV diseases in SOT recipients.

Summary: Recent findings, summarized in the present paper, may be useful to optimize prevention and treatment of CMV infection in SOT.

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Conflict of interest statement

P.A.G. has the following conflict of interest outside the submitted work: Consulting fees from Merck, Sharp & Dohme, Gilead Sciences, Takeda, Biotest, Allovir; member of speakers bureau for Merck, Sharp & Dohme, Gilead Sciences, Takeda.

M.P. reports receiving grants and personal fees from Pfizer, MSD, Menarini, Thermofisher and Dia Sorin outside the submitted work.

Figures

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References

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    2. Excellent review on the place in therapy of new oral antivirals for CMV.

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    2. Very interesting international survey designed to investigate current practices in the management and prevention of CMV infection.

    1. Weinberger S, Steininger C. Reliable quantification of cytomegalovirus DNAemia in Letermovir treated patients. Antiviral Res 2022; 201:105299. - PubMed

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