title: Cytomegalovirus infection in liver transplant recipients: updates on clinical management.
abstract: Cytomegalovirus (CMV) infection is a common complication after liver transplantation, and it is associated with multiple direct and indirect effects. Management of CMV infection and disease has evolved over the years, and clinical guidelines have been recently updated. Universal antiviral prophylaxis and a pre-emptive treatment strategy are options for prevention. A currently-recruiting randomized clinical trial is comparing the efficacy and safety of the two prevention strategies in the highest risk D+R- liver recipients. Drug-resistant CMV infection remains uncommon but is now increasing in incidence. This highlights the currently limited therapeutic options, and the need for novel drug discoveries. Immunotherapy and antiviral drugs with novel mechanisms of action are being investigated, including letermovir (AIC246) and brincidofovir (CMX001). This article reviews the current state of CMV management after liver transplantation, including the updated practice guidelines, and summarizes the data on investigational drugs and vaccines in clinical development.
authors.affiliation: Jasmine Riviere Marcelin, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Jasmine Riviere
authors.initials: JR
authors.lastname: Marcelin
authors.affiliation: Jasmine Riviere Marcelin, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Elena
authors.initials: E
authors.lastname: Beam
authors.affiliation: Jasmine Riviere Marcelin, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States.
authors.forename: Raymund R
authors.initials: RR
authors.lastname: Razonable
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Brincidofovir; Cytomegalovirus; Investigational; Letermovir; Liver transplantation; Prophylaxis; Resistance; Treatment; Valganciclovir