title: Strategies to control human cytomegalovirus infection in adult hematopoietic stem cell transplant recipients.
abstract: Human cytomegalovirus (HCMV) represents the major viral complication after hematopoietic stem cell transplantation. HCMV infection may be controlled by the reconstituting immune system and remain subclinical or can lead to severe systemic and/or organ disease (mainly pneumonia and gastroenteritis) when immune reconstitution is delayed or impaired. In order to prevent the occurrence of HCMV disease, a prompt diagnosis of HCMV infection is mandatory. The adoption of pre-emptive therapy strategies guided by virological monitoring dramatically reduced the occurrence of HCMV disease. However, late-onset end-organ disease may occur in some patients with apparent immune reconstitution. In the near future, introduction of immunological monitoring and immunotherapies could markedly improve management of HCMV infection.
authors.affiliation: Laboratori Sperimentali di Ricerca-Area Trapiantologica, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.|Università della Svizzera Italiana, Institute for Research in Biomedicine, 6500 Bellinzona, Switzerland.
authors.forename: Daniele
authors.initials: D
authors.lastname: Lilleri
authors.affiliation: Laboratori Sperimentali di Ricerca-Area Trapiantologica, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gerna
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000328:Adult; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use; D058070:Asymptomatic Diseases; D001562:Benzimidazoles / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000276:immunology*; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019468:Disease Management; D005759:Gastroenteritis / Q000209:etiology / Q000276:immunology* / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D015166:Monitoring, Immunologic; D063065:Organophosphonates / Q000627:therapeutic use; D011014:Pneumonia / Q000209:etiology / Q000276:immunology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000276:immunology* / Q000517:prevention & control; D011799:Quinazolines / Q000627:therapeutic use; D012263:Ribonucleosides / Q000627:therapeutic use; D004004:Dichlororibofuranosylbenzimidazole / Q000031:analogs & derivatives
chemical_list: D000085:Acetates; D000998:Antiviral Agents; D001562:Benzimidazoles; D003596:Cytosine; D063065:Organophosphonates; D011799:Quinazolines; D012263:Ribonucleosides; C000588473:letermovir; C525733:brincidofovir; C400401:maribavir; D004004:Dichlororibofuranosylbenzimidazole
keywords: hematopoietic stem cell transplantation; human cytomegalovirus; immune reconstitution; pre-emptive therapy