Cytomegalovirus.
Author(s): Griffiths P(1), Lumley S.
Affiliation(s): Author information:
(1)Centre for Virology, UCL Medical School, London, UK.
Publication date & source: 2014, Curr Opin Infect Dis. , 27(6):554-9
PURPOSE OF REVIEW: To consider new treatment options for cytomegalovirus (CMV)
infection, review recent trials, and anticipate their use in clinical practice,
focussing on bone marrow transplantation, congenital infection, and intervention
during pregnancy.
RECENT FINDINGS: Three double-blind randomized placebo-controlled phase 2
proof-of-concept studies have each identified a novel antiviral drug with
activity against CMV infection in bone marrow transplant patients. One of these
(brincidofovir) inhibits the DNA polymerase that is the target of the currently
licensed drug ganciclovir. Another new drug (maribavir) inhibits a protein kinase
which, coincidentally, is the enzyme responsible for activating ganciclovir
through phosphorylation. The third drug (letermovir) inhibits the terminase
enzyme complex responsible for packaging unit length DNA into assembling
virions.In addition, in a double-blind randomized placebo-controlled trial in
neonates with symptomatic congenital CMV infection, a 6-month course of
valganciclovir was superior to the standard 6-week course of the same drug. In
pregnant women with primary CMV infection, administration of hyperimmune
immunoglobulin did not significantly reduce transmission of CMV across the
placenta.
SUMMARY: The ability to diagnose CMV infections reliably in different clinical
settings through application of molecular laboratory methods has ushered in new
ways of evaluating potential new treatments for CMV. Several of these may help
control the diseases caused by this important human pathogen.
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