Cytomegalovirus infection - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Cytomegalovirus (CMV) infection often presents asymptomatically or as an infectious mononucleosis-like syndrome (fever, lymphadenopathy, and atypical lymphocytosis) in people with normal immune systems.
In immunocompromised individuals (patients with AIDS and transplant recipients), the disease manifests with fever, bone marrow suppression, and tissue-invasive conditions such as pneumonitis, hepatitis, colitis, nephritis, and retinitis.
In fetuses, CMV infection can lead to cytomegalic inclusion disease, characterized by severe neurologic abnormalities, intellectual disability, and hearing defects.
Tests for diagnosis include: serology, pp65 antigenemia test, histopathology, and nucleic acid amplification and detection systems, most commonly quantitative polymerase chain reaction-based assays.
In immunocompetent individuals, infection is usually self-limited; therefore, treatment is generally not indicated.

Fundoscopy (left eye) showing area of CMV retinitis inferonasally involving the vascular arcades and the optic disk, associated with vasculitis, and flame hemorrhages

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Definition

Epidemiology

Etiology

Pathophysiology

Images

Fundoscopy (left eye) showing area of CMV retinitis inferonasally involving the vascular arcades and the optic disk, associated with vasculitis, and flame hemorrhages
Chest CT scan of a lung transplant recipient with diffuse interstitial and parenchymal changes as a result of primary CMV pneumonitis
Chest x-ray showing diffuse pulmonary infiltrates in an immunocompromised patient with severe CMV pneumonitis
Active cytomegalovirus infection of lung in AIDS

Citations

Key Articles

Razonable RR, Humar A. Cytomegalovirus in solid organ transplant recipients - guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019 Sep;33(9):e13512.[Abstract]
HIV.gov, US National Institutes of Health. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Jul 2021 [internet publication].[Full Text]
HIV.gov, US National Institutes of Health. Guidelines for the prevention and treatment of opportunistic infections in children with and exposed to HIV. Aug 2023 [internet publication].[Full Text]
Kotton CN, Kumar D, Caliendo AM, et al; The Transplantation Society International CMV Consensus Group. The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2018 Jun;102(6):900-31.[Abstract][Full Text]
Rawlinson WD, Boppana SB, Fowler KB, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis. 2017 Jun;17(6):e177-88.[Abstract]

Other Online Resources

CDC: CMV and congenital CMV infection

Referenced Articles

1. Razonable RR, Humar A. Cytomegalovirus in solid organ transplant recipients - guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019 Sep;33(9):e13512.[Abstract]
2. HIV.gov, US National Institutes of Health. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV. Jul 2021 [internet publication].[Full Text]
3. Ssentongo P, Hehnly C, Birungi P, et al. Congenital cytomegalovirus Infection burden and epidemiologic risk factors in countries with universal screening: a systematic review and meta-analysis. JAMA Netw Open. 2021 Aug 2;4(8):e2120736.[Abstract][Full Text]
4. Hayward GS, Ambinder R, Ciufo D, et al. Structural organization of human herpesvirus DNA molecules. J Invest Dermatol. 1984 Jul;83(1 suppl):29s-41s.[Abstract]
5. Ayre K, Warren BF, Jeffery K, et al. The role of CMV in steroid-resistant ulcerative colitis: a systematic review. J Crohns Colitis. 2009 Sep;3(3):141-8.[Abstract]
6. Limaye AP, Kirby KA, Rubenfeld GD, et al. Cytomegalovirus reactivation in critically ill immunocompetent patients. JAMA. 2008 Jul 23;300(4):413-22.[Abstract][Full Text]
7. Fowler KB, Boppana SB. Congenital cytomegalovirus infection. Semin Perinatol. 2018 Apr;42(3):149-54.[Abstract]
8. Devakumar D, Bamford A, Ferreira MU, et al. Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management. Lancet Infect Dis. 2018 Jan;18(1):e1-13.[Abstract]
9. Boppana SB, Ross SA, Fowler KB. Congenital cytomegalovirus infection: clinical outcome. Clin Infect Dis. 2013 Dec;57 Suppl 4(suppl 4):S178-81.[Abstract][Full Text]
10. Revello M. Pathogenesis and prenatal diagnosis of congenital cytomegalovirus infection. J Clin Virol. 2004 Feb;29(2):71-83.[Abstract]
11. Zuhair M, Smit GSA, Wallis G, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: a systematic review and meta-analysis. Rev Med Virol. 2019 May;29(3):e2034.[Abstract]
12. Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin Infect Dis. 2010 Jun 1;50(11):1439-47.[Abstract][Full Text]
13. Fowler K, Mucha J, Neumann M, et al. A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development. BMC Public Health. 2022 Sep 1;22(1):1659.[Abstract][Full Text]
14. Gantt S, Dionne F, Kozak FK, et al. Cost-effectiveness of universal and targeted newborn screening for congenital cytomegalovirus infection. JAMA Pediatr. 2016 Dec 1;170(12):1173-80.[Abstract][Full Text]
15. Kijpittayarit S, Eid AJ, Brown RA, et al. Relationship between Toll-like receptor 2 polymorphism and cytomegalovirus disease after liver transplantation. Clin Infect Dis. 2007 May 15;44(10):1315-20.[Abstract]
16. Compton T, Kurt-Jones EA, Boehme KW, et al. Human cytomegalovirus activates inflammatory cytokine responses via CD4 and Toll-like receptor 2. J Virol. 2003 Apr;77(8):4588-96.[Abstract][Full Text]
17. Einsele H, Kapp M, Grigoleit GU. CMV-specific T cell therapy. Blood Cells Mol Dis. 2008 Jan-Feb;40(1):71-5.[Abstract]
18. Hernandez C, Mabilangan C, Burton C, et al. Cytomegalovirus transmission in mismatched solid organ transplant recipients: are factors other than anti-viral prophylaxis at play? Am J Transplant. 2021 Dec;21(12):3958-70.[Abstract][Full Text]
19. Helanterä I, Schachtner T, Hinrichs C, et al. Current characteristics and outcome of cytomegalovirus infections after kidney transplantation. Transpl Infect Dis. 2014 Aug;16(4):568-77.[Abstract]
20. Razonable RR, Rivero A, Rodriguez A, et al. Allograft rejection predicts the occurrence of late-onset cytomegalovirus (CMV) disease among CMV-mismatched solid organ transplant patients receiving prophylaxis with oral ganciclovir. J Infect Dis. 2001 Dec 1;184(11):1461-4.[Abstract]
21. Boeckh M, Nichols WG. The impact of cytomegalovirus serostatus of donor and recipient before hematopoietic stem cell transplantation in the era of antiviral prophylaxis and preemptive therapy. Blood. 2004 Mar 15;103(6):2003-8.[Abstract]
22. Tedesco-Silva H, Felipe C, Ferreira A, et al. Reduced incidence of cytomegalovirus infection in kidney transplant recipients receiving everolimus and reduced tacrolimus doses. Am J Transplant. 2015 Oct;15(10):2655-64.[Abstract][Full Text]
23. Chavarot N, Divard G, Scemla A, et al. Increased incidence and unusual presentations of CMV disease in kidney transplant recipients after conversion to belatacept. Am J Transplant. 2021 Jul;21(7):2448-58.[Abstract][Full Text]
24. Tedesco-Silva H, Pascual J, Viklicky O, et al. Safety of everolimus with reduced calcineurin inhibitor exposure in de novo kidney transplants: an analysis from the randomized TRANSFORM study. Transplantation. 2019 Sep;103(9):1953-63.[Abstract][Full Text]
25. Kaminski H, Kamar N, Thaunat O, et al. Incidence of cytomegalovirus infection in seropositive kidney transplant recipients treated with everolimus: a randomized, open-label, multicenter phase 4 trial. Am J Transplant. 2022 May;22(5):1430-41.[Abstract][Full Text]
26. Weng MT, Tung CC, Lee YS, et al. Cytomegalovirus colitis in hospitalized inflammatory bowel disease patients in Taiwan: a referral center study. BMC Gastroenterol. 2017 Feb 13;17(1):28.[Abstract][Full Text]
27. Razonable RR. Epidemiology of cytomegalovirus disease in solid organ and hematopoietic stem cell transplant recipients. Am J Health Syst Pharm. 2005 Apr 15;62(8 suppl 1):S7-13.[Abstract]
28. Kenneson A, Cannon MJ. Review and meta-analysis of congenital cytomegalovirus (CMV) infection. Rev Med Virol. 2007 Jul-Aug;17(4):253-76.[Abstract]
29. Boucoiran I, Yudin M, Poliquin V, et al. Guideline No. 420: Cytomegalovirus infection in pregnancy. J Obstet Gynaecol Can. 2021 Jul;43(7):893-908.[Abstract]
30. American College of Obstetricians and Gynecologists. Practice bulletin no. 151: Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Jun 2015 [internet publication].
31. Nichols WG, Price TH, Gooley T, et al. Transfusion-transmitted cytomegalovirus infection after receipt of leukoreduced blood products. Blood. 2003 May 15;101(10):4195-200.[Abstract][Full Text]
32. HIV.gov, US National Institutes of Health. Guidelines for the prevention and treatment of opportunistic infections in children with and exposed to HIV. Aug 2023 [internet publication].[Full Text]
33. Ljungman P, Griffiths P, Paya C. Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis. 2002 Apr 15;34(8):1094-7.[Abstract][Full Text]
34. Razonable RR, Åsberg A, Rollag H, et al. Virologic suppression measured by a cytomegalovirus (CMV) DNA test calibrated to the World Health Organization international standard is predictive of CMV disease resolution in transplant recipients. Clin Infect Dis. 2013 Jun;56(11):1546-53.[Abstract][Full Text]
35. Preiksaitis JK, Hayden RT, Tong Y, et al. Are we there yet? Impact of the first International Standard for cytomegalovirus DNA on the harmonization of results reported on plasma samples. Clin Infect Dis. 2016 Sep 1;63(5):583-9.[Abstract]
36. Alsanea MS, Al-Qahtani AA, Almaghrabi RS, et al. Diagnosis of human cytomegalovirus drug resistance mutations in solid organ transplant recipients-a review. Diagnostics (Basel). 2024 Jan 18;14(2):203.[Abstract][Full Text]
37. Eid AJ, Bakri SJ, Kijpittayarit S, et al. Clinical features and outcomes of cytomegalovirus retinitis after transplantation. Transpl Infect Dis. 2008 Feb;10(1):13-8.[Abstract]
38. Shreeniwas R, Schulman LL, Berkmen YM, et al. Opportunistic bronchopulmonary infections after lung transplantation: clinical and radiographic findings. Radiology. 1996 Aug;200(2):349-56.[Abstract]
39. Franquet T, Lee KS, Müller NL. Thin-section CT findings in 32 immunocompromised patients with cytomegalovirus pneumonia who do not have AIDS. AJR Am J Roentgenol. 2003 Oct;181(4):1059-63.[Abstract][Full Text]
40. Manuel O, Meylan PR, Rotman S, et al. Oral valganciclovir for cytomegalovirus colitis after liver transplantation. Transplantation. 2007 Jan 27;83(2):239-40.[Full Text]
41. Ljungman P, Boeckh M, Hirsch HH, et al; Disease Definitions Working Group of the Cytomegalovirus Drug Development Forum. Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. 2017 Jan 1;64(1):87-91.[Abstract]
42. Razonable RR, Paya CV, Smith TF. Role of the laboratory in the diagnosis and management of cytomegalovirus infection in hematopoietic and solid organ transplant recipients. J Clin Microbiol. 2002 Mar;40(3):746-52.[Abstract][Full Text]
43. Wohl DA, Kendall MA, Andersen J, et al; A5030 Study Team. Low rate of CMV end-organ disease in HIV-infected patients despite low CD4+ cell counts and CMV viremia: results of ACTG protocol A5030. HIV Clin Trials. 2009 May-Jun;10(3):143-52.[Abstract][Full Text]
44. Boppana SB, Rivera LB, Fowler KB, et al. Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N Engl J Med. 2001 May 3;344(18):1366-71.[Abstract][Full Text]
45. Donner C, Liesnard C, Brancart F, et al. Accuracy of amniotic fluid testing before 21 weeks' gestation in prenatal diagnosis of congenital cytomegalovirus infection. Prenat Diagn. 1994 Nov;14(11):1055-9.[Abstract]
46. Michaels MG, Greenberg DP, Sabo DL, et al. Treatment of children with congenital cytomegalovirus infection with ganciclovir. Pediatric Infect Dis J. 2003 Jun;22(6):504-9.[Abstract]
47. Lagasse N, Dhooge I, Govaert P, et al. Congenital CMV infections and hearing loss. Acta Otorhinolaryngology Belg. 2000;54(4):431-6.[Abstract]
48. Humar A, Michaels M; AST ID Working Group on Infectious Disease Monitoring. American Society of Transplantation recommendations for screening, monitoring and reporting of infectious complications in immunosuppression trials in recipients of organ transplantation. Am J Transplant. 2006 Feb;6(2):262-74.[Abstract][Full Text]
49. Chemaly RF, Chou S, Einsele H, et al. Definitions of resistant and refractory cytomegalovirus infection and disease in transplant recipients for use in clinical trials. Clin Infect Dis. 2019 Apr 8;68(8):1420-26.[Abstract][Full Text]
50. Centers for Disease Control and Prevention. Congenital cytomegalovirus (cCMV) infection and disease: 2024 case definition. Feb 2024 [internet publication]. [Full Text]
51. Kotton CN, Kumar D, Caliendo AM, et al; The Transplantation Society International CMV Consensus Group. The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2018 Jun;102(6):900-31.[Abstract][Full Text]
52. Asberg A, Humar A, Rollag H, et al. Oral valganciclovir is noninferior to intravenous ganciclovir for the treatment of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant. 2007 Sep;7(9):2106-13.[Abstract]
53. Muller M, Wandel S, Colebunders R, et al; IeDEA Southern and Central Africa. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis. 2010 Apr;10(4):251-61.[Abstract]
54. Kuppermann BD, Quiceno JI, Flores-Aguilar M, et al. Intravitreal ganciclovir concentration after intravenous administration in AIDS patients with cytomegalovirus retinitis: implications for therapy. J Infect Dis. 1993 Dec;168(6):1506-9.[Abstract]
55. Avery RK, Alain S, Alexander BD, et al. Maribavir for refractory cytomegalovirus infections with or without resistance post-transplant: results from a phase 3 randomized clinical trial. Clin Infect Dis. 2022 Sep 10;75(4):690-701.[Abstract][Full Text]
56. Papanicolaou GA, Avery RK, Cordonnier C, et al. Treatment for first cytomegalovirus infection post-hematopoietic cell transplant in the AURORA trial: a multicenter, double-blind, randomized, phase 3 trial comparing maribavir with valganciclovir. Clin Infect Dis. 2024 Mar 20;78(3):562-72.[Abstract][Full Text]
57. Razonable RR. Oral antiviral drugs for treatment of cytomegalovirus in transplant recipients. Clin Microbiol Infect. 2023 Sep;29(9):1144-9.[Abstract]
58. Rawlinson WD, Boppana SB, Fowler KB, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis. 2017 Jun;17(6):e177-88.[Abstract]
59. Kimberlin DW, Jester PM, Sánchez PJ, et al; National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Valganciclovir for symptomatic congenital cytomegalovirus disease. N Engl J Med. 2015 Mar 5;372(10):933-43.[Abstract][Full Text]
60. Kimberlin DW, Lin CY, Sanchez PJ, et al. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Pediatr. 2003 Jul;143(1):16-25.[Abstract]
61. Oliver SE, Cloud GA, Sánchez PJ, et al; National Institute of Allergy, Infectious Diseases Collaborative Antiviral Study Group. Neurodevelopmental outcomes following ganciclovir therapy in symptomatic congenital cytomegalovirus infections involving the central nervous system. J Clin Virol. 2009 Dec;(46 suppl 4):S22-6.[Abstract]
62. Bonaros N, Mayer B, Schachner T, et al. CMV-hyperimmune globulin for preventing cytomegalovirus infection and disease in solid organ transplant recipients: a meta-analysis. Clin Transplant. 2008 Jan-Feb;22(1):89-97.[Abstract]
63. Pass RF, Zhang C, Evans A, et al. Vaccine prevention of maternal cytomegalovirus infection. N Engl J Med. 2009 Mar 19;360(12):1191-9.[Abstract][Full Text]
64. Griffiths PD, Stanton A, McCarrell E, et al. Cytomegalovirus glycoprotein-B vaccine with MF59 adjuvant in transplant recipients: a phase 2 randomised placebo-controlled trial. Lancet. 2011 Apr 9;377(9773):1256-63.[Abstract][Full Text]
65. Kharfan-Dabaja MA, Boeckh M, Wilck MB, et al. A novel therapeutic cytomegalovirus DNA vaccine in allogeneic haemopoietic stem-cell transplantation: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis. 2012 Apr;12(4):290-9.[Abstract]
66. Vincenti F, Budde K, Merville P, et al. A randomized, phase 2 study of ASP0113, a DNA-based vaccine, for the prevention of CMV in CMV-seronegative kidney transplant recipients receiving a kidney from a CMV-seropositive donor. Am J Transplant. 2018 Dec;18(12):2945-54.[Abstract][Full Text]
67. Nakamura R, La Rosa C, Longmate J, et al. Viraemia, immunogenicity, and survival outcomes of cytomegalovirus chimeric epitope vaccine supplemented with PF03512676 (CMVPepVax) in allogeneic haemopoietic stem-cell transplantation: randomised phase 1b trial. Lancet Haematol. 2016 Feb;3(2):e87-98.[Abstract][Full Text]
68. Das R, Blázquez-Gamero D, Bernstein DI, et al. Safety, efficacy, and immunogenicity of a replication-defective human cytomegalovirus vaccine, V160, in cytomegalovirus-seronegative women: a double-blind, randomised, placebo-controlled, phase 2b trial. Lancet Infect Dis. 2023 Dec;23(12):1383-94.[Abstract]
69. Scheinberg P, Melenhorst JJ, Brenchley JM, et al. The transfer of adaptive immunity to cytomegalovirus (CMV) during hematopoietic stem cell transplantation is dependent on the specificity and phenotype of CMV-specific T cells in the donor. Blood. 2009 Dec 3;114(24):5071-80.[Abstract]
70. Snyder LD, Chan C, Kwon D, et al. Polyfunctional T-cell signatures to predict protection from cytomegalovirus after lung transplantation. Am J Respir Crit Care Med. 2016 Jan 1;193(1):78-85.[Abstract]
71. Manuel O, Husain S, Kumar D, et al. Assessment of cytomegalovirus-specific cell-mediated immunity for the prediction of cytomegalovirus disease in high-risk solid-organ transplant recipients: a multicenter cohort study. Clin Infect Dis. 2013 Mar;56(6):817-24.[Abstract][Full Text]
72. Yong MK, Shigle TL, Kim YJ, et al. American Society for Transplantation and Cellular Therapy Series: #4 - cytomegalovirus treatment and management of resistant or refractory infections after hematopoietic cell transplantation. Transplant Cell Ther. 2021 Dec;27(12):957-67.[Abstract][Full Text]
73. Hakki M, Aitken SL, Danziger-Isakov L, et al. American Society for Transplantation and Cellular Therapy Series: #3-prevention of cytomegalovirus infection and disease after hematopoietic cell transplantation. Transplant Cell Ther. 2021 Sep;27(9):707-19.[Abstract][Full Text]
74. Ljungman P, de la Camara R, Robin C, et al. Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019 Aug;19(8):e260-e272.[Abstract]
75. Khalil A, Heath P, Jones C, et al; Royal College of Obstetricians and Gynaecologists. Congenital cytomegalovirus infection: update on treatment: Scientiﬁc Impact Paper no. 56. BJOG. 2018 Jan;125(1):e1-11.[Abstract][Full Text]
76. Chen S, Pawelec G, Trompet S, et al. Associations of cytomegalovirus infection with all-cause and cardiovascular mortality in multiple observational cohort studies of older adults. J Infect Dis. 2021 Feb 3;223(2):238-46.[Abstract][Full Text]
77. Manuel O, Kralidis G, Mueller NJ, et al; Swiss Transplant Cohort Study. Impact of antiviral preventive strategies on the incidence and outcomes of cytomegalovirus disease in solid organ transplant recipients. Am J Transplant. 2013 Sep;13(9):2402-10.[Abstract][Full Text]
78. Martin-Gandul C, Mueller NJ, Pascual M, et al. The impact of infection on chronic allograft dysfunction and allograft survival after solid organ transplantation. Am J Transplant. 2015 Dec;15(12):3024-40.[Abstract][Full Text]
79. American Society of Transplantation, American Society of Transplant Surgeons. Cytomegalovirus. Am J Transplant. 2004;4(suppl 10):51-8.[Full Text]
80. Preiksaitis JK, Brennan DC, Fishman J, et al. Canadian society of transplantation consensus workshop on cytomegalovirus management in solid organ transplantation final report. Am J Transplant. 2005 Feb;5(2):218-27.[Abstract][Full Text]
81. Portillo V, Masouridi-Levrat S, Royston L, et al. Revisiting cytomegalovirus serology in allogeneic hematopoietic cell transplant recipients. Clin Infect Dis. 2024 Feb 17;78(2):423-9.[Abstract][Full Text]
82. Vernooij RW, Michael M, Ladhani M, et al. Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev. 2024 May 3;5(5):CD003774.[Abstract]
83. Spector SA, McKinley GF, Lalezari JP, et al. Oral ganciclovir for the prevention of cytomegalovirus disease in persons with AIDS. N Engl J Med. 1996 Jun 6;334(23):1491-7.[Abstract][Full Text]
84. Brosgart CL, Louis TA, Hillman DW, et al. A randomized, placebo-controlled trial of the safety and efficacy of oral ganciclovir for prophylaxis of cytomegalovirus disease in HIV-infected individuals. Terry Beirn Community Programs for Clinical Research on AIDS. AIDS. 1998 Feb 12;12(3):269-77.[Abstract]
85. Marty FM, Ljungman P, Chemaly RF, et al. Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N Engl J Med. 2017 Dec 21;377(25):2433-44.[Abstract][Full Text]
86. Royston L, Royston E, Masouridi-Levrat S, et al. Letermovir primary prophylaxis in high-risk hematopoietic cell transplant recipients: a matched cohort study. Vaccines (Basel). 2021 Apr 12;9(4):372.[Abstract][Full Text]
87. Limaye AP, Budde K, Humar A, et al. Letermovir vs valganciclovir for prophylaxis of cytomegalovirus in high-risk kidney transplant recipients: a randomized clinical trial. JAMA. 2023 Jun 6;e239106.[Abstract][Full Text]
88. Shahar-Nissan K, Pardo J, Peled O, et al. Valaciclovir to prevent vertical transmission of cytomegalovirus after maternal primary infection during pregnancy: a randomised, double-blind, placebo-controlled trial. Lancet. 2020 Sep 12;396(10253):779-85.[Abstract]
89. Chatzakis C, Shahar-Nissan K, Faure-Bardon V, et al. The effect of valacyclovir on secondary prevention of congenital cytomegalovirus infection, following primary maternal infection acquired periconceptionally or in the first trimester of pregnancy. An individual patient data meta-analysis. Am J Obstet Gynecol. 2024 Feb;230(2):109-17.e2.[Abstract]
90. Revello MG, Lazzarotto T, Guerra B, et al; CHIP Study Group. A randomized trial of hyperimmune globulin to prevent congenital cytomegalovirus. N Engl J Med. 2014 Apr 3;370(14):1316-26.[Abstract][Full Text]
91. Hughes BL, Clifton RG, Rouse DJ, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. A trial of hyperimmune globulin to prevent congenital cytomegalovirus infection. N Engl J Med. 2021 Jul 29;385(5):436-44.[Abstract]
92. Kalil AC, Levitsky J, Lyden E, et al. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann Intern Med. 2005 Dec 20;143(12):870-80.[Abstract]
93. Small LN, Lau J, Snydman DR. Preventing post-organ transplant cytomegalovirus disease with ganciclovir: a meta-analysis comparing prophylactic and preemptive therapies. Clin Infect Dis. 2006 Oct 1;43(7):869-80.[Abstract]
94. Strippoli GF, Hodson EM, Jones C, et al. Preemptive treatment of cytomegalovirus viremia to prevent cytomegalovirus disease in solid organ transplant recipients. Transplantation. 2006 Jan 27;81(2):139-45.[Abstract]
95. Owers DS, Webster AC, Strippoli GF, et al. Pre-emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev. 2013;(2):CD005133.[Abstract][Full Text]
96. Singh N, Winston DJ, Razonable RR, et al. Effect of preemptive therapy vs antiviral prophylaxis on cytomegalovirus disease in seronegative liver transplant recipients with seropositive donors: a randomized clinical trial. JAMA. 2020 Apr 14;323(14):1378-87.[Abstract][Full Text]