Advances in cytomegalovirus-preventive strategies in solid organ transplantation: defending pre-emptive therapy

Abstract

Prevention of cytomegalovirus (CMV) infection is an important part of clinical care provided to patients after solid organ transplantation. While the optimal preventive strategy has not been defined, most centers rely on universal prophylaxis or pre-emptive therapy. This article comments on recent studies designed to identify strategies that effectively reduce the incidence of late-onset CMV disease as the main problem associated with prophylaxis, and on recent data regarding the development of CMV-specific immunity depending on the CMV-preventive regimen used. Despite an apparent trend to prefer prophylaxis in clinical practice, this approach does not seem to be based on robust evidence.

Keywords::

• CMV-specific T-cell immunity
• cytomegalovirus
• organ transplantation
• pre-emptive therapy
• prophylaxis
• valacyclovir
• valganciclovir

Financial & competing interests disclosure

This study was supported by Research Project No. MSM0021620819 ‘Replacement of and Support to Some Vital Organs’, awarded by the Ministry of Education, Youth, and Physical Training of the Czech Republic. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.