✦ LIBER ✦

Prophylaxis for CMV should not now replace pre-emptive therapy in solid organ transplantation

✍ Scribed by Vincent C. Emery

Publisher: John Wiley and Sons
Year: 2001
Tongue: English
Weight: 66 KB
Volume: 11
Category: Article
ISSN: 1052-9276
DOI: 10.1002/rmv.310

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✦ Synopsis

Abstract

Pre‐emptive therapy (PET) initiated on the basis of HCMV positivity in the blood using sensitive methods such as PCR, nucleic acid sequence based amplification or antigenaemia offers several advantages for the management of HCMV infection. These include the ability to target antiviral drug therapy to those most at risk of future disease, minimising drug exposure and maximising cost‐benefit. In addition, allowing limited replication to occur also provides immune stimulation which will be important for future control of HCMV replication. In contrast, prophylaxis is a high‐cost strategy which exposes all patients to potentially toxic drugs, does not facilitate immune priming and leads to the development of late HCMV infection and disease in high‐risk patients. Copyright © 2001 John Wiley & Sons, Ltd.

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## Abstract Cytomegalovirus is a significant cause of morbidity and mortality in transplantation. Controversy exists concerning whether prophylactic or pre‐emptive therapy is the optimal strategy for preventing CMV disease. In addition, CMV impacts the transplanted graft, transplant recipient and t