4.6 Article

Positive HCMV DNAemia in stem cell recipients undergoing letermovir prophylaxis is expression of abortive infection

Journal

AMERICAN JOURNAL OF TRANSPLANTATION
Volume 21, Issue 4, Pages 1622-1628

Publisher

WILEY
DOI: 10.1111/ajt.16450

Keywords

clinical research/practice; infection and infectious agents - viral: Cytomegalovirus (CMV); infectious disease; molecular biology; molecular biology: DNA; translational research/science

Funding

  1. Ministero della Salute, Fondazione IRCCS Policlinico San Matteo, Ricerca Corrente [80720, 80207]

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This study highlights the importance of considering the clinical relevance of HCMV DNAemia during LMV prophylaxis in allo-HSCTRs.
Letermovir (LMV) inhibits HCMV replication by binding to components of the HCMV-terminase complex showing a potential role in prevention of HCMV-related complications in allogenic hematopoietic stem cell transplant recipients (allo-HSCTRs). However, little is known about breakthrough HCMV infection and the relevance of HCMV DNAemia during prophylaxis. We reported the results of a multicenter prospective study involving five Italian centers in the management of HCMV DNAemia in 75 adult HCMV-seropositive allo-HSCTRs undergoing LMV prophylaxis. The aim of the present study was to characterize the presence of real HCMV reactivation during LMV prophylaxis. Then, the presence of circulating infectious HCMV particles was determined by virus isolation and degradation of free-floating viral DNA. This report provides the first evidence that during LMV prophylaxis the clinical relevance of HCMV DNAemia should be critically considered.

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