Advances in the Development of Therapeutics for Cytomegalovirus Infections. (5th March 2020)

• Record Type: Journal Article
• Authors: Acosta, Edward; Bowlin, Terry; Brooks, Jennifer; Chiang, Lillian; Hussein, Islam; Kimberlin, David; Kauvar, Lawrence M; Leavitt, Randi; Prichard, Mark; Whitley, Richard
• Is Part Of: Journal of infectious diseases. Volume 221(2020)Supplement 1
• Page Start: S32
• Page End: S44
• Publication Date: 2020-03-05
• Subjects: congenital cytomegalovirus -- antiviral therapy -- ganciclovir -- valganciclovir -- sirtuins -- letermovir -- cyclopropovir -- maribavir -- monoclonal antibodies; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiz493
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: The development of therapeutics for cytomegalovirus (CMV) infections, while progressing, has not matched the pace of new treatments of human immunodeficiency virus (HIV) infections; nevertheless, recent developments in the treatment of CMV infections have resulted in improved human health and perhaps will encourage the development of new therapeutic approaches. First, the deployment of ganciclovir and valganciclovir for both the prevention and treatment of CMV infections and disease in transplant recipients has been further improved with the licensure of the efficacious and less toxic letermovir. Regardless, late-onset CMV disease, specifically pneumonia, remains problematic. Second, the treatment of congenital CMV infections with valganciclovir has beneficially improved both hearing and neurologic outcomes, both fundamental advances for these children. In these pediatric studies, viral load was decreased but not eliminated. Thus, an important lesson learned from studies in both populations is the need for new antiviral agents and the necessity for combination therapies as has been shown to be beneficial in the treatment of HIV infections, among others. The development of monoclonal antibodies, sirtuins, and cyclopropovir may provide new treatment options.