Abstract
Human cytomegalovirus (hCMV) is one of the most common causes of congenital infection in the post-rubella era, representing a major public health concern. Although most cases are asymptomatic in the neonatal period, congenital CMV (cCMV) disease can result in permanent impairment of cognitive development and represents the leading cause of non-genetic sensorineural hearing loss. Moreover, even if hCMV mostly causes asymptomatic or pauci-symptomatic infections in immunocompetent hosts, it may lead to severe and life-threatening disease in immunocompromised patients. Since immunity reduces the severity of disease, in the last years, the development of an effective and safe hCMV vaccine has been of great interest to pharmacologic researchers. Both hCMV live vaccines—e.g., live-attenuated, chimeric, viral-based—and non-living ones—subunit, RNA-based, virus-like particles, plasmid-based DNA—have been investigated. Encouraging data are emerging from clinical trials, but a hCMV vaccine has not been licensed yet. Major difficulties in the development of a satisfactory vaccine include hCMV’s capacity to evade the immune response, unclear immune correlates for protection, low number of available animal models, and insufficient general awareness. Moreover, there is a need to determine which may be the best target populations for vaccine administration. The aim of the present paper is to examine the status of hCMV vaccines undergoing clinical trials and understand barriers limiting their development.
Highlights
EpidemiologyHuman cytomegalovirus (hCMV), which is one of the eight herpesviruses known to infect humans, is widespread all around the world and is mostly asymptomatic in immunocompetent people [1]
This evidence might prove that maternal immunity confers protection and pregnant women and women of child-bearing age could be a good target for a Human cytomegalovirus (hCMV) vaccine
A very important step for the development of hCMV vaccine is represented by the identification of new viral glycoproteins and cellular receptors implicated in virus entry in host cells, as previously described [22]
Summary
Human cytomegalovirus (hCMV), which is one of the eight herpesviruses known to infect humans, is widespread all around the world and is mostly asymptomatic in immunocompetent people [1]. Non-primary infection occurs when the fetus is infected because of viral reactivation or in case of maternal reinfection with a different hCMV strain [7]. About three-quarters of cCMV infections are caused by non-primary maternal infection, given the high rates of hCMV seropositivity among women of childbearing age [8]. In AIDS patients, the virus causes mostly sight-threatening retinitis that commonly occurs when the CD4+ T-cell count falls below 50 cells/mm3 Less frequently, it is associated with polyradiculopathy, meningoencephalitis, pneumonitis (often in co-infection with Pneumocystis jirovecii or Aspergillus fumigatus), and gastrointestinal tract infections [46]. Maternal hCMV serology is most useful in the first trimester because of the higher risk of disease in newborns when primary infection occurs in the early stages of pregnancy [52]. Considering antiviral toxicity, it is important to monitor patients regularly with clinical examination and blood tests
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
