Westall Glen P, Gottlieb David, Hughes Peter, Marinelli Tina, Rawlinson William D, Ritchie David, Sasadeusz Joe, Yong Michelle K
Department of Respiratory Medicine, Alfred Health, Monash University, Melbourne, Victoria, Australia.
Blood Transplant and Cell Therapies Program, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
Intern Med J. 2025 Jan;55(1):12-19. doi: 10.1111/imj.16587. Epub 2024 Dec 2.
Cytomegalovirus (CMV) infections continue to be associated with significant morbidity and mortality following solid organ transplantation and haemopoietic stem cell transplantation. Advances in understanding the biology of CMV in the immunosuppressed host will translate into improved management approaches and better clinical outcomes. Updated definitions of resistant and refractory CMV infections will lead to more consistent reporting of CMV outcomes, better inform appropriate antiviral strategies and influence clinical trial design. Improved knowledge of the immunological control of CMV in the immunosuppressed host has led to novel diagnostics, emerging therapeutic cellular therapies and the development of an informed rationale for prophylactic and pre-emptive strategies. As the boundaries of transplantation are extended, new patterns of CMV infection are being recognised. Finally, recent studies support the use of novel antiviral therapies in transplant recipients in the appropriate clinical setting. In this review, we provide an update on important new and emerging concepts in the management of CMV in immunosuppressed transplant recipients.
巨细胞病毒（CMV）感染在实体器官移植和造血干细胞移植后仍然与显著的发病率和死亡率相关。在理解免疫抑制宿主中CMV生物学方面的进展将转化为改进的管理方法和更好的临床结果。对抗性和难治性CMV感染的更新定义将导致CMV结果报告更加一致，为适当的抗病毒策略提供更好的信息并影响临床试验设计。对免疫抑制宿主中CMV免疫控制的深入了解催生了新型诊断方法、新兴的治疗性细胞疗法以及预防性和先发制人策略的合理依据。随着移植边界的扩展，CMV感染的新模式正在被认识。最后，最近的研究支持在适当的临床环境中对移植受者使用新型抗病毒疗法。在本综述中，我们提供了免疫抑制移植受者CMV管理中重要的新出现概念的最新情况。
