Antiviral Treatment for Cytomegalovirus Diseases

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Viral Immunology, Vaccines, and Antivirals".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 6296

Special Issue Editor

1. Center for Vaccines and Immunity, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
2. College of Medicine, Ohio State University, Columbus, OH, USA
Interests: cytomegalovirus; CMV

Special Issue Information

Dear Colleagues,

Cytomegalovirus is a beta-herpesvirus that has evolved to exist in human populations, with a seroprevalence ranging from 50% to near-universal seropositivity among adult populations worldwide. However, in special populations such as the immunocompromised host or the infected fetus, cytomegalovirus can cause viral disease, long-term disabilities, and even death. The historical mainstays of antiviral drug therapy against cytomegalovirus have included ganciclovir, valganciclovir, cidofovir, and foscarnet, but their effectiveness may be influenced by viral mutations, differences in host metabolism (pharmacokinetics/pharmacodynamics), and drug interactions in various clinical settings. Recently, new antivirals have been approved or are in Phase I-III clinical trials for CMV treatment and prevention, including letermovir and maribavir, as are emerging approaches that utilize T cell and NK cell therapies in immunocompromised hosts. Antiviral therapies are also used to mitigate the long-term neurologic consequences of congenital CMV infection, and to prevent in utero transmission among high-risk pregnant women. This Special Issue will highlight current and emerging treatments against CMV infection and specific therapeutic issues relevant to various at-risk patient groups.

Dr. Masako Shimamura
Guest Editor

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Published Papers (3 papers)

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Review

11 pages, 255 KiB  
Review
Antiviral Treatment of Maternal and Congenital Cytomegalovirus (CMV) Infections
by Swetha Pinninti and Suresh Boppana
Viruses 2023, 15(10), 2116; https://doi.org/10.3390/v15102116 - 19 Oct 2023
Cited by 1 | Viewed by 1203
Abstract
Human Cytomegalovirus (HCMV) is a ubiquitous member of the Herpesviridae family, responsible for the most common congenital viral infection—congenital Cytomegalovirus (cCMV) infection. While a majority of HCMV infections in children and adults are asymptomatic, HCMV is well known to cause severe infections in [...] Read more.
Human Cytomegalovirus (HCMV) is a ubiquitous member of the Herpesviridae family, responsible for the most common congenital viral infection—congenital Cytomegalovirus (cCMV) infection. While a majority of HCMV infections in children and adults are asymptomatic, HCMV is well known to cause severe infections in the immunocompromised individual and maternal infections with variable long-term sequelae after maternal–fetal transmission with primary or nonprimary infections. HCMV seroprevalence and cCMV incidence vary by geographic area and demographic characteristics like race and socioeconomic status. While cCMV birth prevalence ranges from 0.2% to 6% in different parts of the world, it is influenced by regional HCMV seroprevalence rates. HCMV screening during pregnancy is not routinely offered due to lack of awareness, hurdles to accurate diagnosis, and lack of well-established effective treatment options during pregnancy. This review will focus on antiviral treatment options currently available for use during pregnancy and in the newborn period for the treatment of maternal and congenital HCMV infections. Full article
(This article belongs to the Special Issue Antiviral Treatment for Cytomegalovirus Diseases)
14 pages, 596 KiB  
Review
An Update on Current Antiviral Strategies to Combat Human Cytomegalovirus Infection
by Kingshuk Panda, Deepti Parashar and Rajlakshmi Viswanathan
Viruses 2023, 15(6), 1358; https://doi.org/10.3390/v15061358 - 12 Jun 2023
Cited by 6 | Viewed by 2403
Abstract
Human cytomegalovirus (HCMV) remains an essential global concern due to its distinct life cycle, mutations and latency. As HCMV is a herpesvirus, it establishes a lifelong persistence in the host through a chronic state of infection. Immunocompromised individuals are at risk of significant [...] Read more.
Human cytomegalovirus (HCMV) remains an essential global concern due to its distinct life cycle, mutations and latency. As HCMV is a herpesvirus, it establishes a lifelong persistence in the host through a chronic state of infection. Immunocompromised individuals are at risk of significant morbidity and mortality from the virus. Until now, no effective vaccine has been developed to combat HCMV infection. Only a few antivirals targeting the different stages of the virus lifecycle and viral enzymes are licensed to manage the infection. Therefore, there is an urgent need to find alternate strategies to combat the infection and manage drug resistance. This review will provide an insight into the clinical and preclinical antiviral approaches, including HCMV antiviral drugs and nucleic acid-based therapeutics. Full article
(This article belongs to the Special Issue Antiviral Treatment for Cytomegalovirus Diseases)
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16 pages, 288 KiB  
Review
Adoptive Immunotherapy for Prophylaxis and Treatment of Cytomegalovirus Infection
by Christopher P. Ouellette
Viruses 2022, 14(11), 2370; https://doi.org/10.3390/v14112370 - 27 Oct 2022
Cited by 9 | Viewed by 2024
Abstract
Cytomegalovirus (CMV), a member of the Herpesviridae family, is frequent among hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients in absence of antiviral prophylaxis, and is a major cause of morbidity and mortality in these vulnerable populations. Antivirals such ganciclovir, valganciclovir, [...] Read more.
Cytomegalovirus (CMV), a member of the Herpesviridae family, is frequent among hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients in absence of antiviral prophylaxis, and is a major cause of morbidity and mortality in these vulnerable populations. Antivirals such ganciclovir, valganciclovir, and foscarnet are the backbone therapies, however drug toxicity and antiviral resistance may render these agents suboptimal in treatment. Newer therapies such as letermovir and maribavir have offered additional approaches for antiviral prophylaxis as well as treatment of drug resistant CMV infection, though may be limited by cost, drug intolerance, or toxicity. Adoptive immunotherapy, the transfer of viral specific T-cells (VSTs), offers a new approach in treatment of drug-resistant or refractory viral infections, with early clinical trials showing promise with respect to efficacy and safety. In this review, we will discuss some of the encouraging results and challenges of widespread adoption of VSTs in care of immunocompromised patients, with an emphasis on the clinical outcomes for treatment and prophylaxis of CMV infection among high-risk patient populations. Full article
(This article belongs to the Special Issue Antiviral Treatment for Cytomegalovirus Diseases)
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