Valganciclovir for the prevention and treatment of CMV in solid organ transplant recipients.
BACKGROUND
Cytomegalovirus (CMV) infection is the most common viral infectious complication after solid organ transplantation (SOT). Ganciclovir is the first-line anti-CMV treatment, but its low oral bioavailability limits its use and generally intravenous treatment has been mandatory. Valganciclovir is a prodrug of ganciclovir with > 60% bioavailability and has become an alternative to intravenous ganciclovir.


METHODS
The review examines the use of valganciclovir both for prophylaxis and treatment of CMV disease in SOT.


RESULTS
The reader will be provided an overview of the literature on valganciclovir related to efficacy and safety in SOT recipients. Furthermore, the use of valganciclovir in less well-documented areas, such as patients with potential problems with oral absorption of drugs, pediatric patients and patients with life-threatening CMV disease, is discussed.


CONCLUSIONS
The major take home message is that valganciclovir is a documented option for prevention and treatment of CMV in most SOT recipients. Given the ease of use and clinical efficacy it allows for substituting intravenous treatment in the majority of cases and has resulted in a major change of therapy for CMV in solid organ transplanted patients.
Asberg
Anders
A
University of Oslo, School of Pharmacy, PO Box 1068, Blindern, 0316 Oslo, Norway. anders.asberg@farmasi.uio.no
Rollag
Halvor
H
Hartmann
Anders
A
D000998:Antiviral Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001682:Biological Availability; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D015774:Ganciclovir / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D016377:Organ Transplantation; D011355:Prodrugs; D000077562:Valganciclovir
D000998:Antiviral Agents; D011355:Prodrugs; D000077562:Valganciclovir; D015774:Ganciclovir