Abstract
Cytomegalovirus (CMV) is a human herpes virus that causes significant morbidity and mortality in immunosuppressed children. CMV primary infection causes a clinically mild disease in healthy children, usually in early childhood; the virus then utilises several mechanisms to establish host latency, which allows for periodic reactivation, particularly when the host is immunocompromised. It is this reactivation that is responsible for the significant morbidity and mortality in immunocompromised children. We review CMV infection in the primary immunodeficient host, including early identification of these infants by newborn screening to allow for CMV infection prevention strategies. Furthermore, clinical CMV is discussed in the context of children treated with secondary immunodeficiency, particularly paediatric cancer patients and children undergoing haematopoietic stem cell transplant (HSCT). Treatments for CMV are highlighted and include CMV immunotherapy.
Highlights
Human cytomegalovirus (CMV) or human herpes virus-5 is a member of the Betaherpesvirinae subfamily of the family Herpesviridae [1]
The immunosuppressed patients at risk are those with primary T cell immunodeficiency, HIV/AIDS patients, solid organ transplant patients and those undergoing chemotherapy for haematological malignancies with or without the additional immunosuppression, from syngeneic and allogeneic haemopoietic cell transplant as well as the foetus, leading to congenital CMV
Oral probenecid is usually given with each cidofovir dose to reduce nephrotoxicity; probenecid is known to interact with the metabolism or renal tubular secretion of many drugs [27]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Human cytomegalovirus (CMV) or human herpes virus-5 is a member of the Betaherpesvirinae subfamily of the family Herpesviridae [1]. It is a double-stranded DNA virus that causes primary infection, usually in childhood; it is not cleared from the host and becomes latent in white blood cells. CMV has significant implications for children who are or become immunodeficient This includes those with a primary immune disorder or a secondary immune disorder, acquired due to medical treatment such as immunosuppressive therapy, haemopoietic bone marrow transplant (HSCT) or solid organ transplant [2].
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