Medication
There are three systemic drugs approved for CMV treatment: ganciclovir, or its prodrug valganciclovir, foscarnet, and cidofovir. An anti-sense therapeutic, ISIS 2922, is also approved specifically as in intravitreal treatment for CMV retinitis.
Nutrition
· Prophylactic strategies included use of acyclovir, valacyclovir, ganciclovir, maribavir, brincidofovir, and letermovir compared with placebo or a comparator antiviral.
What is another name for cytomegalovirus prophylaxis?
Human Cytomegalovirus (HCMV) infection is widespread and can result in severe sequelae in susceptible populations. Primary HCMV infection of naïve individuals results in life-long latency characterized by frequent and sporadic reactivations. HCMV infection elicits a robust antibody response, includi …
What is the treatment for cytomegalovirus?
· Opinion statement. In treating cytomegalovirus (CMV) infection, it is crucial to decide whether one is treating pre-emptively or if one is treating established disease. Disease may be further divided into viral syndrome and tissue-invasive disease. Generally, mild disease in immunosuppressed patients may be treated with oral valganciclovir.
Is universal prophylaxis necessary after human cytomegalovirus (HCT)?
· Acyclovir/valacyclovir prophylaxis. High-dose acyclovir (500 mg/m 2 intravenously 3 times daily, followed by 800 mg 4 times daily [adult dosing]) can reduce the risk of CMV infection and possibly CMV disease. 44, 45 The study by Prentice et al 45 reported improved survival rates, although the mechanism for this improvement is not clear.
Is Ganciclovir a universal prophylaxis agent against cytomegalovirus (CMV)?
· As discussed by the authors, prophylactic therapy has primarilybeen evaluated for acyclovir and ganciclovir (Cytovene). Despite its favorabletoxicity profile, the modest activity of acyclovir against CMV makes it asuboptimal agent for the purpose of preventing CMV disease.
What is the best treatment for CMV?
Ganciclovir (Cytovene) is the first antiviral medication approved for the treatment of CMV infection. Ganciclovir, given intravenously, is the drug of choice for the treatment of CMV infection. Side effects include fever, rash, diarrhea, anemia, and low white blood cell and platelet counts.
Is there a treatment for CMV?
There's no cure for CMV. The virus stays inactive in your body and can cause more problems later. This reactivation is most common in people who've had stem cell and organ transplants.
What is foscarnet used to treat?
Foscarnet is principally used for the treatment of ganciclovir-resistant cytomegalovirus (CMV) infections in patients with the acquired immunodeficiency syndrome (AIDS) or in transplant recipients.
What is the causative agent of cytomegalovirus?
Cytomegalovirus infection is caused by the human cytomegaloviruses (also known as “salivary gland viruses”). These are a subgroup of infective agents closely related to the herpes group of viruses. Like other herpes viruses, they may remain latent for years in people.
Which of the following vaccine used for the treatment of cytomegalovirus?
Table 1PhaseVaccineAntigens Used1AVX601gB, pp65, IE11HCMV-MVA Triplexpp65, UL123/IE1-exon4, UL122/IE2-exon51HB-101gB, pp652ALVAC-pp65pp6521 more rows•Nov 1, 2017
Can you treat CMV with acyclovir?
At present, there is no effective therapy for human cytomegalovirus (CMV) infections. Although acyclovir inhibits in vitro clinical isolates of CMV, preliminary human trials suggest that acyclovir may not be successful as a single antiviral agent in treating CMV infections.
What type of drug is ganciclovir?
Ganciclovir is in a class of medications called antivirals. It works by preventing the spread of CMV disease or slowing the growth of CMV.
When is cisplatin used?
Cisplatin, a chemotherapy drug, is best known for curing testicular cancer. It is also used in the treatment of a wide range of other cancers, including lung, bladder, cervical, and ovarian cancers. Cisplatin and other similar platinum-based drugs were developed with National Cancer Institute (NCI) support.
What is cidofovir for?
Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people with acquired immunodeficiency syndrome (AIDS). Cidofovir is in a class of medications called antivirals. It works by slowing the growth of CMV.
How does ganciclovir work?
Ganciclovir works by slowing the growth of the CMV virus. It helps control CMV retinitis and decrease the risk of blindness. It also helps prevent the spread of infection to other areas of the body. Ganciclovir is not a cure for CMV disease.
How do you prevent CMV infection?
PreventionWash your hands often. ... Avoid contact with tears and saliva when you kiss a child. ... Avoid sharing food or drinking out of the same glass as others. ... Be careful with disposable items. ... Clean toys and countertops. ... Practice safe sex.
How is CMV treated in transplant patients?
How is CMV in transplant patients treated? If you have an active CMV infection that's causing symptoms, you will need treatment. Antiviral medicines like ganciclovir or valganciclovir can help. These medicines can help control the virus.
How long does it take to get rid of CMV?
Symptoms will generally go away after 2 weeks. Symptoms of recurring CMV vary, depending on which organs the virus has affected. Areas likely to be affected are the eyes, lungs, or digestive system.
What happens if you are CMV positive?
The majority of children born who experience a CMV infection before birth are healthy and normal. However, 10 to 15% may have complications such as hearing loss, neurological abnormalities, or decreased motor skills. Infants who are infected with CMV after they are born rarely experience any long-term complications.
What happens if CMV is left untreated?
If untreated, it can spread throughout the body, infecting organ after organ. It may cause respiratory problems, damage to the central nervous system, bleeding ulcers in the digestive system, and CMV retinitis, which can lead to blindness.
How long does cytomegalovirus last?
Signs and symptoms. Most healthy individuals who have a CMV infection will not have symptoms. However, when symptoms are present, they are often similar to those of glandular fever. Severity and duration can vary but, on average, will last for two to three weeks.
What is the purpose of CMV prophylaxis?
Cytomegalovirus (CMV) prophylaxis is medication used to prevent the reactivation of CMV infection. CMV is a common virus that infects the majority of people. Once a person has been infected with CMV the virus stays in the body as a dormant or inactive infection and is usually kept in check by the immune system. If the immune system is compromised in some way or lowered, as in the case of immunosuppressive medicines, the infection can be reactivated causing serious illness. The aim of CMV prophylaxis is to keep the CMV suppressed so that it does not cause an active infection.
What is the medication for CMV?
Medications for CMV Prophylaxis. Other names: Cytomegalovirus Prophylaxis. Cytomegalovirus (CMV) prophylaxis is medication used to prevent the reactivation of CMV infection. CMV is a common virus that infects the majority of people. Once a person has been infected with CMV the virus stays in the body as a dormant or inactive infection ...
What is CMV in the body?
CMV is a common virus that infects the majority of people. Once a person has been infected with CMV the virus stays in the body as a dormant or inactive infection and is usually kept in check by the immune system. If the immune system is compromised in some way or lowered, as in the case of immunosuppressive medicines, ...
What is the CMV virus?
CMV is a common virus that infects the majority of people. Once a person has been infected with CMV the virus stays in the body as a dormant or inactive infection and is usually kept in check by the immune system.
What is an EUA?
EUA. An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives. Pregnancy Category. A.
Is CMV a preemptive treatment?
The preemptive treatment strategy is highly effective at managing CMV infection; however, its success depends largely on the presence of CMV in the blood before the onset of disease and the early detection of CMV. The latter depends on the adherence to the testing schedule. Occasionally, there will be missed cases of disease that are not preceded by CMV DNAemia or pp65 antigenemia. Disease may also occur because of missed surveillance tests or surveillance tests that are spaced too far apart.
Is Maribavir a prophylactic drug?
Maribavir is a new and, as yet, unli censed antiviral agent that is presently being investigated as a prophylactic drug. A randomized, placebo-controlled dose-ranging phase 2 study has been published with promising results, showing significantly lower risk of CMV infection and borderline reduction of CMV disease, compared with placebo. 59 Toxicity was also limited, mainly consisting of gastrointestinal side effects, but no marrow toxicity was found. Enrollment in a large phase 3 trial has been completed, and results are expected to be available in 2009.
What is the CMV after hematopoietic cell transplantation?
Cytomegalovirus (CMV) continues to cause major complications after hematopoietic cell transplantation (HCT). Over the past decade, most centers have adopted preemptive antiviral treatment or prophylaxis strategies to prevent CMV disease. Both strategies are effective but also have shortcomings with presently available drugs. Here, we review aspects of CMV treatment and prevention in HCT recipients, including currently used drugs and diagnostics, ways to optimize preemptive therapy strategies with quantitative polymerase chain reaction assays, the use of prophylaxis, management of CMV disease caused by wild-type or drug-resistant strains, and future strategies.
What is the risk of CMV transmission?
If only a CMV-seropositive donor is available for a CMV-seronegative patient, the risk of transmission of CMV by the stem cell product to the recipient is approximately 20% to 30%. 7, 26
Does ganciclovir cause neutropenia?
Ganciclovir given at engraftment causes prolonged neutropenia, leading to more invasive bacterial and fungal infections. 47, 49, 51 In addition, a substantial number of patients not at risk for disease (ie, 60%-65%) will unnecessarily receive a potentially marrow-toxic drug. The neutropenia might at least, in part, be prevented or treated with G-CSF, but this adds to the cost. Nonrandomized studies have been reported and used a pretransplantation induction course of ganciclovir from day −8 to −1 followed by lower maintenance doses of ganciclovir (ie, 5 mg/kg, 3 times a week) starting at engraftment. 52-55 The results have been varying, with some of the studies showing high rates of CMV disease. 52, 54 Thus, this strategy may be unsafe in high-risk patients.
Is foscarnet a prophylaxis?
The role of foscarnet for prophylaxis of CMV disease remains undefined because no controlled studies have been published. Three uncontrolled studies have been reported, 56-58 with some breakthroughs of CMV infection and disease. Foscarnet is associated with dose-dependent renal toxicity and electrolyte abnormalities.
How long does it take for CMV to double?
Studies by Emery and Griffiths 60 have shown that the doubling time of CMV is only 1 to 2 days on average and that the degree of immunosuppression determines the in vivo replication dynamics.
What is the cytomegalovirus?
Cytomegalovirus (CMV, human herpesvirus type 5) can cause infections that have a wide range of severity. A syndrome of infectious mononucleosis that lacks severe pharyngitis is common. Severe focal disease, including retinitis, can develop in HIV-infected patients and in organ transplant recipients and other immunocompromised patients.
What is the best treatment for CMV?
Prophylaxis or preemptive treatment (actively monitoring patients by viral load and giving antiviral drugs to those with evidence of infection) is effective for preventing CMV disease in solid organ or hematopoietic cell transplant recipients infected with CMV and at risk of CMV disease. Drugs used include ganciclovir, valganciclovir, and foscarnet.
How to diagnose CMV?
Diagnosis of CMV Infection 1 Detection of CMV antigen or DNA 2 Urine culture in infants 3 Often biopsy in immunocompromised patients 4 Serologic testing
What are the symptoms of CMV?
Diagnosis of CMV Infection 1 Healthy people with mononucleosis-like syndromes 2 Immunocompromised patients with gastrointestinal, CNS, or retinal symptoms 3 Neonates with systemic disease
How is CMV transmitted?
CMV (human herpesvirus type 5) is transmitted through blood, body fluids, or transplanted organs. Infection may be acquired transplacentally or during birth. Prevalence increases with age; 60 to 90% of adults have CMV infection (resulting in lifelong latent infection). Lower socioeconomic groups tend to have a higher prevalence.
What is the CMV infection?
In the terminal phase of AIDS, CMV infection causes retinitis in up to 40% of patients and causes funduscopically visible retinal abnormalities. Ulcerative disease of the colon (with abdominal pain and gastrointestinal bleeding) or of the esophagus (with odynophagia) may occur.
Can CMV be detected in blood?
Quantitative detection of CMV antigen or DNA in the peripheral blood can also be very helpful because an elevated or rising CMV viral load is often highly suggestive of invasive disease. Diagnosis of CMV infection in infants can be made by urine culture.
What tests can detect CMV?
Diagnosis. Laboratory tests — including tests of blood and other body fluids or tests of tissue samples — can detect CMV.
Why is CMV testing important?
Testing for CMV can also be important if you have a weakened immune system. For example, if you have HIV or AIDS, or if you've had a transplant, your doctor may want to monitor you regularly.
Can you test for CMV while pregnant?
During pregnancy and after delivery. If you're pregnant, testing to determine whether you've ever been infected with CMV can be important. Pregnant women who have already developed CMV antibodies have a very small chance of a reactivation infecting their unborn children.
When to do amniocentesis?
If your doctor suspects your baby has congenital CMV, it's important to test the baby within the first three weeks of birth.
When to test for CMV?
If your doctor suspects your baby has congenital CMV, it's important to test the baby within the first three weeks of birth. If your baby has CMV, your doctor likely will recommend additional tests to check the health of the baby's organs, such as the liver and kidneys.
How to write a doctor's note?
Before your appointment take these steps: 1 Write down any symptoms you or your child is experiencing. Include signs and symptoms even if they seem minor, such as low-grade fever or fatigue. 2 Write down questions to ask your doctor. Your time with your doctor is limited, so it can be useful to prepare a list of questions.