Valganciclovir to prevent or treat cytomegalovirus disease in organ transplantation.
Cytomegalovirus (CMV) is generally considered the most significant pathogen to infect patients following organ transplantation. Significant improvements have been achieved in the management of CMV disease over recent years, especially since the introduction of oral drugs such as oral ganciclovir followed by valganciclovir (VGC), a prodrug of ganciclovir with enhanced bioavailability. Several randomized controlled trials have shown that VGC is an efficacious and convenient oral drug to prevent or treat CMV disease in solid-organ transplant recipients. In this article, we discuss the clinical and pharmacological experience with the use of VGC for the management of CMV in solid-organ transplant recipients. Finally, novel strategies to further reduce the incidence of CMV disease after transplantation are also reviewed.
Transplantation Center, University Hospital of Lausanne (CHUV), 1011 Lausanne, Switzerland. oriol.manuel@chuv.ch
Oriol
O
Manuel
Nancy
N
Perrottet
Manuel
M
Pascual
D000284:Administration, Oral; D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D016207:Cytokines / Q000096:biosynthesis; D003587:Cytomegalovirus / Q000187:drug effects* / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control* / Q000821:virology; D054796:Drug Dosage Calculations; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D016867:Immunocompromised Host; D016377:Organ Transplantation; D017410:Practice Guidelines as Topic; D011355:Prodrugs / Q000493:pharmacokinetics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D000077562:Valganciclovir; D019562:Viral Load / Q000187:drug effects; D014779:Virus Replication / Q000187:drug effects
D000998:Antiviral Agents; D016207:Cytokines; D011355:Prodrugs; D000077562:Valganciclovir; D015774:Ganciclovir