Double-stranded, DNA herpesvirus that infects man and other species, producing unique large cells with inclusion bodies.
Also known as human herpesvirus # 5 or HHV-5
In immunocompentent individuals, most CMV infections are mild and may produce a viral syndrome resembling infectious mononucleosis.
Approximately 50 - 90% of immunocompetent adults >40 years old have antibodies (IgG) to CMV. In otherwise healthy adults, CMV remains inactive or latent, but ready to be become active under “favorable conditions”.
Valganciclovir vs. ganciclovir – PV 16000 - 1 percent of patients developing CMV disease while receiving therapy. Time-to-onset of CMV disease and to viremia were delayed with valganciclovir; rates of acute allograft rejection were generally lower with valganciclovir.Also, lower resistance (2% vs. none). Caution with neutropenia.
Investigative phase – leflunamide, valacyclovir.
Efficacy and safety of valganciclovir vs. oral ganciclovir for prevention of CMV disease in solid organ transplant recipients. Paya C et al. J Transplant 2004 Apr;4(4):611-20.
CMV disease occurred most frequently in D+/R- recipients with zero HLA-DR matches.
In addition, allograft survival at five years was significantly decreased among those with CMV disease and zero matches compared to patients with CMV disease and one or two HLA-DR matches (16 versus 76 percent, respectively).
These results suggest that, to enhance allograft survival, consideration should be given to HLA-DR matching plus CMV status in the allocation of kidneys.