Investigation of CMV disease in immunocompromised patients

Abstract

Cytomegalovirus (CMV) is a recognised cause of morbidity and mortality in immunocompromised individuals. This review will concentrate on recent advances in the understanding of the complex interplay between the host and parasite and the pathological consequences of perturbation of the host immune system. The classic view of CMV as a slowly replicating virus is challenged by recent in vivo findings suggesting that active replication occurs dynamically in the human host, with a doubling time of approximately one day. In addition, CMV load plays a major role in viral pathogenesis, such that increased CMV replication is a significant risk factor for disease in all immunocompromised groups studied to date. These studies focus attention on understanding the virological and immunological determinants of enhanced viral replication and its pathological consequences.

Cytomegalovirus infection in non-immunosuppressed critically ill patients

“…It is seen that expression of HLA Class II is impaired in CMV infected cells. Though this is an oversimplified explanation, these escape mechanisms devised by CMV help it to maintain latency without being eliminated by the immune mechanisms [2,3]. Immunosuppression in the host for any reasons leads to replication of the virus which was kept in check by the immune mechanisms.…”

“…The most common mechanism proposed for CMV infection or disease in such critically ill patients is as a result of reactivation of CMV virus and not primarily due to primary infection. CMV has the ability to establish latency in various different types of cells unlike other herpes viruses which largely remain localized [2,3]. Monocytes, CD 34+ haematopoietic progenitor cells, and endothelial cells are the major sites where latent CMV is present.…”

Promotion of Tumorigenesis and Clinical Implications of Viral Infection in Breast Cancer

“…HCMV causes morbidity and mortality in AIDS patients, transplant recipients, and other immunocompromised individuals [70]. Primary HCMV infection in pregnant women is rare but results in congenital infection in about two thirds of cases.…”

Infectious Diseases and Clinical Complications During Treatment in CLL

“…Advances in molecular virology coupled with improvements in diagnostic methods and treatment options have vastly improved ability to manage CMV infection, but many uncertainties remain, including the mechanisms of persistence and pathogenesis and its hypothesized roles in a variety of human illnesses (Boeckh & Geballe, 2011). It is a recognized cause of morbidity and mortality in immunocompromised individuals (Emery, 2001). Primary infection with CMV is followed by persistence of the virus in a latent form.…”