Advances in the prevention and treatment of cytomegalovirus infection in hospital patients

Abstract

The incidence of cytomegalovirus (CMV), a common pathogen for hospital patients, can be reduced by providing virus-free blood products. The virus can also be transmitted via solid organ allografts and the efficacy of matching donor and recipient for improving overall patient survival needs formal evaluation. Patients at risk of future disease can be detected by surveillance cultures, whose prognostic value is good for bone marrow transplant recipients; formal evaluation in other groups of patients is required. This is particularly important now that ganciclovir and foscarnet are licensed for the therapy of life-threatening CMV infections and other therapies are available on an investigational basis. Resistance to ganciclovir has been described and is likely to be an increasing problem. Placebo-controlled trials have shown that prophylaxis with α-interferon, immunoglobulin or high-dose acyclovir can significantly reduce CMV infection and CMV disease.