CMV - immunocompromised host

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

CMV (cytomegalovirus)

CMV - immunocompromised host

Alternative Names:

Cytomegalovirus - immunocompromised host
Treatment:

The objective of treatment is to stop the replication of the virus within the body through the use of antiviral agents. These drugs DO NOT eliminate the virus from the body -- they only keep it from dividing.

The most commonly used drugs are ganciclovir, valganciclovir, foscarnet, and cidofovir. These are used in patients in whom CMV disease is established throughout the body.

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For CMV infection of the eye, the drug valgancyclovir has been shown to suppress progression of CMV retinitis in HIV patients. A new drug named Fomivirsen has recently been approved by the FDA, and works via direct injection into the eye.

Foscarnet and cidofovir are associated with significant nephrotoxicity (kidney damage) and electrolyte abnormalities, which may require supplementation by intravenous electrolytes. Ganciclovir can cause neutropenia (severe depletion of white blood cells).

There is evidence that resistance to some of these drugs exists, especially to ganciclovir. Newer medications to fight CMV are in development.

Expectations (prognosis):

CMV infection in the immunocompromised host can be life-threatening, and the severity of the disease is dependent on the strength of the individual's immune system. Individuals who have undergone bone marrow transplant have been shown to have the highest mortality risk.

Any immunocompromised person, whether an HIV patient, organ transplant recipient, bone marrow transplant recipient, or medically immunosuppressed individual, should seek out medical advice if any signs of infection should occur.

Complications: