Bottino Paolo, Pastrone Lisa, Curtoni Antonio, Bondi Alessandro, Sidoti Francesca, Zanotto Elisa, Cavallo Rossana, Solidoro Paolo, Costa Cristina
Microbiology and Virology Unit, A.O.U. "Città della Salute e della Scienza di Torino", 10126 Turin, Italy.
Pneumology Unit, A.O.U. "Città della Salute e della Scienza di Torino", 10126 Turin, Italy.
Microorganisms. 2023 Sep 22;11(10):2372. doi: 10.3390/microorganisms11102372.
Human cytomegalovirus (HCMV) is a herpesvirus capable of establishing a lifelong persistence in the host through a chronic state of infection and remains an essential global concern due to its distinct life cycle, mutations, and latency. It represents a life-threatening pathogen for immunocompromised patients, such as solid organ transplanted patients, HIV-positive individuals, and hematopoietic stem cell recipients. Multiple antiviral approaches are currently available and administered in order to prevent or manage viral infections in the early stages. However, limitations due to side effects and the onset of antidrug resistance are a hurdle to their efficacy, especially for long-term therapies. Novel antiviral molecules, together with innovative approaches (e.g., genetic editing and RNA interference) are currently in study, with promising results performed in vitro and in vivo. Since HCMV is a virus able to establish latent infection, with a consequential risk of reactivation, infection management could benefit from preventive treatment for critical patients, such as immunocompromised individuals and seronegative pregnant women. This review will provide an overview of conventional antiviral clinical approaches and their mechanisms of action. Additionally, an overview of proposed and developing new molecules is provided, including nucleic-acid-based therapies and immune-mediated approaches.
人巨细胞病毒（HCMV）是一种疱疹病毒，能够通过慢性感染状态在宿主体内建立终身持续性感染，由于其独特的生命周期、突变和潜伏性，它仍然是一个全球关注的重要问题。对于免疫功能低下的患者，如实体器官移植患者、HIV阳性个体和造血干细胞接受者，它是一种危及生命的病原体。目前有多种抗病毒方法可供使用并进行给药，以在早期预防或控制病毒感染。然而，由于副作用和抗药耐药性的出现所带来的局限性，是其疗效的一个障碍，特别是对于长期治疗而言。新型抗病毒分子以及创新方法（如基因编辑和RNA干扰）目前正在研究中，在体外和体内均取得了有前景的结果。由于HCMV是一种能够建立潜伏感染的病毒，随之而来存在重新激活的风险，对于重症患者，如免疫功能低下个体和血清学阴性的孕妇，感染管理可能会受益于预防性治疗。本综述将概述传统抗病毒临床方法及其作用机制。此外，还将概述已提出和正在研发的新分子，包括基于核酸的疗法和免疫介导的方法。
