a Division of Infectious Diseases and the William J von Liebig Center for Transplantation and Clinical Regeneration , Mayo Clinic College of Medicine and Science , Rochester , MI , USA.
Expert Rev Clin Pharmacol. 2018 Aug;11(8):773-788. doi: 10.1080/17512433.2018.1501557. Epub 2018 Jul 26.
Cytomegalovirus (CMV) is a common opportunistic infection that causes significant morbidity and preventable mortality after solid-organ and allogeneic hematopoietic stem cell transplantation. Areas covered: Current strategies of pharmacological treatment of CMV in solid-organ and hematologic stem cell transplantation are reviewed. The role of the newly approved drug, letermovir, and other novel investigational compounds is discussed. The complementary role of viral and immunologic monitoring in guiding the optimal role of pharmacologic agents on the management of CMV after transplantation is highlighted. Advances in immunotherapeutics are highlighted. Expert commentary: With advances in therapeutic and diagnostic modalities, the management of CMV infection and disease after transplantation continues to evolve. The authors provide a succinct yet comprehensive review of the current prevention and treatment for CMV infection and disease in transplant recipients. The role of the newly approved drug, letermovir, for CMV prevention is highlighted in the context of current prevention strategies after allogeneic hematopoietic stem cell transplantation. The emerging role of cell-mediated immunologic monitoring, which complements the established function of viral load testing, is emphasized. Finally, the integration of novel antiviral therapies, standardized molecular tests, immunologic assays, and immunotherapeutics are discussed.
巨细胞病毒（CMV）是一种常见的机会性感染，在实体器官和异基因造血干细胞移植后会导致显著的发病率和可预防的死亡率。
本文回顾了实体器官和造血干细胞移植中 CMV 的药物治疗策略。讨论了新批准的药物乐替拉韦和其他新型研究化合物的作用。强调了病毒和免疫监测在指导移植后药物治疗 CMV 的最佳作用中的补充作用。突出了免疫治疗的进展。
随着治疗和诊断方式的进步，移植后 CMV 感染和疾病的管理不断发展。作者提供了对移植受者 CMV 感染和疾病的当前预防和治疗的简洁而全面的综述。在异基因造血干细胞移植后当前的预防策略背景下，强调了新批准的药物乐替拉韦在 CMV 预防中的作用。强调了细胞介导的免疫监测的新兴作用，该监测补充了病毒载量检测的既定功能。最后，讨论了新型抗病毒疗法、标准化分子检测、免疫测定和免疫治疗的整合。
