title: [Optimization strategies in management of CMV infection in transplant patients].
abstract: Currently, two therapeutic strategies are applied for preventing the development of CMV end-organ disease in transplant recipients: universal prophylaxis and preemptive antiviral therapy. Both are potentially optimable. As for the former strategy, precisely identifying patients at greatest risk of viremia would allow for a targeted prophylaxis. In this sense several genotypic, immunological and biological markers have been described that could be ancillary to that purpose. As for the latter strategy, combined monitoring of plasma CMV DNA load and peripheral levels of CMV-specific CD8 + and CD4 + IFN-γ producing T cells would permit a more rationale use of antivirals, thus avoiding overtreatment and derived toxicity.
authors.affiliation: David Navarro, Servicio de Microbiología, Hospital Clínico Universitario de Valencia, Fundación INCLIVA y Departamento de Microbiología de la Universitat de Valencia, Spain. david.navarro@uv.es.
authors.forename: David
authors.initials: D
authors.lastname: Navarro
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000517:prevention & control* / Q000628:therapy / Q000821:virology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016377:Organ Transplantation
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents