Therapeutic Strategies for Severe Cytomegalovirus Infection: Current Situation and Perspectives

Abstract

Cytomegalovirus (CMV) infection is a common complication in immunodeficient patients, especially after haematopoietic stem cell or solid organ transplantation, and it is associated with multiple direct and indirect effects. Universal antiviral prophylaxis and a pre-emptive treatment strategy are options for prevention. However, therapeutic options ([val]ganciclovir, foscarnet, cidofovir) are still limited and could expose to severe toxicities. Moreover, drug-resistant CMV infection is now increasing in incidence. After many years during which we have seen few tangible advances in terms of new antiviral drugs, we are now experiencing an exciting period of late-stage drug development, characterized by a series of phase III trials incorporating a variety of novel agents (especially letermovirir and brincidofovir).This article reviews the current state of treatment of severe CMV infections and summarizes the data on investigational drugs in clinical development.