Comparative clinical manifestations and immune effects of cytomegalovirus infections following distinct types of immunosuppression

Ong, David S. Y.; Chong, Ga-Lai M.; Chemaly, Roy F.; Cremer, Olaf L.

doi:10.1016/j.cmi.2022.05.034

Cited by 9 publications

(12 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pneumonitis is the most frequent manifestation of CMV infection in SOT patients, seen in 15% CMV-positive patients who did not receive prophylaxis [49]. Among the signs and symptoms are cough, shortness of breath, hypoxia, tachypnea, and pulmonary infiltrates on radiographic imaging in addition to the identification of CMV in bronchoalveolar lavage specimens.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Unlike the pulmonary consolidation seen in bacterial infection, CMV causes diffuse interstitial infiltrates. CMV pneumonitis is associated with a greater than 60% mortality rate in solid organ transplant recipients [49]. However, mortality rates are significantly decreased with donor and recipient serostatus matching and the use of antiviral prophylaxis.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Invasion of the gastrointestinal (GI) system by CMV is the second most seen manifestation of CMV infection and is seen in 81% of cases. CMV invasion usually occurs in the lower GI tract (62%) leading to colitis or enteritis [50]; however, upper GI esophagitis is seen in 27% of cases and often appears as linear, deep, erythematous ulcerations along the wall of the esophagus [41,49]. The diagnosis of CMV infection requires a high index of suspicion due to its variable presentation and nonspecific symptoms.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…Histology is useful in diagnosing invasive disease by identifying infected cells as well as highlighting host inflammatory responses. While the confirmation of systemic infection does not require histopathological evaluation, it is necessary to definitively diagnose end organ disease [49]. Tissue-invasive disease is diagnosed by histological examination and by the detection of CMV antigens using immunohistochemistry [61].…”

Section: Diagnosismentioning

confidence: 99%

See 3 more Smart Citations

Cytomegalovirus and Kidney Transplantation: An Update

Senere¹,

Rogozinski²,

George³

et al. 2023

OBM Transplant

View full text Add to dashboard Cite

Cytomegalovirus (CMV) infection is the most common infection affecting kidney transplant recipients [1]. CMV may be present as asymptomatic viremia or with symptoms ranging from mild to significant tissue-invasive disease [1-3]. Optimal kidney graft function and survival requires that transplant care teams carefully assess individual patient risk of CMV [2, 3]. Appropriate patient surveillance and prophylaxis are essential to ensure the best long-term kidney transplant results. Effective treatment of CMV disease requires a high degree of suspicion and appropriate diagnostic tests. The choice of antiviral medication and duration of treatment are important considerations to ensure optimal patient outcomes and kidney graft function and survival.

show abstract

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Clinical Manifestationsmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Cytomegalovirus and Kidney Transplantation: An Update

Senere¹,

Rogozinski²,

George³

et al. 2023

OBM Transplant

View full text Add to dashboard Cite

show abstract

“…Cytomegalovirus (CMV) is an important cause of both morbidity and mortality in solid organ or stem-cell transplanted patients and immunocompromised hosts, including cancer patients [1][2][3]. CMV reactivation especially in immunocompromised patients may rapidly progress to a fatal CMV disease.…”

Section: Introductionmentioning

confidence: 99%

Current management of CMV infection in cancer patients (solid tumors). Epidemiology and therapeutic strategies

García-Bustos¹,

Salavert²,

Blanes³

et al. 2022

Rev Esp Quimioter

View full text Add to dashboard Cite

Little evidence is available regarding the incidence of CMV disease in patients with solid cancers. Latest data show that approximately 50 % of these patients with CMV PCR positivity developed clinically relevant CMV-viremia, and would require specific therapy. In the clinical arena, CMV reactivation is an important differential diagnosis in the infectological work up of these patients, but guidelines of management on this subject are not yet available. CMV reactivation should be considered during differential diagnosis for patients with a severe decline in lymphocyte counts when receiving chemoradiotherapy or immunochemotherapy with lymphocyte-depleting or blocking agents. Monitoring of CMV reactivation followed by the implementation of preemptive strategies or the establishment of early antiviral treatment improves the prognosis and reduces the morbidity and mortality of these patients.

show abstract

Immunovirology of cytomegalovirus infection in allogeneic stem cell transplant recipients undergoing prophylaxis with letermovir: A narrative review

Solano

Giménez

Albert

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

On November 7, 2017, the US Food and Drug Administration approved the use of letermovir (LMV) for prophylaxis of cytomegalovirus (CMV) infection in adult CMV‐seropositive allogeneic stem cell transplant recipients. After 6 years of use, a large body of real‐world experience has been accumulated that validates the Phase III clinical trial results, in which LMV was shown to significantly reduce the risk of clinically significant CMV infection—defined as CMV end‐organ disease or CMV DNAemia requiring pre‐emptive antiviral therapy (PET)—and increase survival up to Week 24 after treatment inception. Notwithstanding, several issues still need to be settled, thus further investigation is required. First, since viral DNA may accumulate as a result of LMV‐driven abortive CMV infection, what is the optimal viral load threshold in the blood that would prompt LMV prophylaxis interruption and PET inception? Should this be adapted to the patient's risk? Second, what is the impact of LMV prophylaxis on the reconstitution of functional CMV‐specific T‐cell responses? Would it be a wise approach to individually tailor the duration of LMV treatment according to the number of peripheral blood CMV‐specific T cells at the end of regular prophylaxis? Third, how frequently do LMV‐resistant strains arise while patients are on LMV prophylaxis and how could this be minimized? Here, we discuss the literature addressing these topics.

show abstract

Comparative clinical manifestations and immune effects of cytomegalovirus infections following distinct types of immunosuppression

Cited by 9 publications

References 102 publications

Cytomegalovirus and Kidney Transplantation: An Update

Cytomegalovirus and Kidney Transplantation: An Update

Current management of CMV infection in cancer patients (solid tumors). Epidemiology and therapeutic strategies

Immunovirology of cytomegalovirus infection in allogeneic stem cell transplant recipients undergoing prophylaxis with letermovir: A narrative review

Contact Info

Product

Resources

About