Immunity Risk Associated With Cytomegalovirus Infection After Organ Transplantation

Abstract

Cytomegalovirus (CMV), a member of the Herpesviridae family, is frequently seen in hematopoietic cell transplant (HCT) and solid organ transplant (SOT) patients and is a major cause of morbidity and mortality in absence of antiviral prophylaxis in the transplant patients. CMV infection can cause serious problems in organ transplant patients following transplantation, in which the virus could reactivate or could contract a new infection, both result in signs of an active CMV infection consequently leading to organ rejection. CMV generates a robust and diverse innate and adaptive immune response and infects epithelial cells, macrophages, and T lymphocytes. During a three tier infective reaction cycle, it   establishes lifetime latency within its host. Ganciclovir , Valganciclovir and Foscarnet though remain successful as treatment strategies against CMV infection, they suffer from some major side effects like leukopenia, drug toxicity and some resistance development. So more recent medicines like letermovir and maribavir have provided new insights as therapy of drug resistant CMV infection. The demand for efficient and well-tolerated medicines still remains a challenge. Early clinical trials have shown potential for adoptive immunotherapy, which involves the virus specific T-cells (VSTs) as drug regime for highly resistant viral infections. With a focus on the clinical strategy for the challenge of CMV infection, this review encompasses positive findings and problems of the widespread use of VSTs to treat immunocompromised patients.