Article
Immunology
Hannah N. Imlay, Daniel R. Kaul
Summary: Until recently, available drugs for CMV prevention and treatment in transplant patients have been limited by toxicity and resistance issues, with letermovir being the first new drug approved for CMV prevention since 2003. The efficacy of letermovir in treating established CMV infection or disease remains largely unstudied, while the investigational agent maribavir shows promise as a preemptive treatment option with unique mechanisms of action. Ongoing studies will define the efficacy of these drugs in patients with refractory or resistant CMV disease.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Surgery
Tobias Veit, Dieter Munker, Juergen Barton, Katrin Milger, Teresa Kauke, Bruno Meiser, Sebastian Michel, Michael Zoller, Hans Nitschko, Oliver T. Keppler, Jurgen Behr, Nikolaus Kneidinger
Summary: This study assessed the therapeutic efficacy of letermovir in lung transplant recipients with difficult to treat CMV infections. Most patients responded rapidly to letermovir treatment, showing significant reduction in CMV viral load and clearance of infection. However, a small percentage of patients developed a mutation conferring resistance to letermovir.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Review
Virology
Carlos Solano, Estela Gimenez, Eliseo Albert, Jose L. Pinana, David Navarro
Summary: Letermovir has been approved by the US FDA for prophylaxis of CMV infection in adult allogeneic stem cell transplant recipients. Real-world experience has validated the clinical trial results, showing that it significantly reduces the risk of CMV infection and improves survival. However, further investigation is needed to address issues such as viral load threshold, impact on CMV-specific T-cell responses, and prevention of LMV-resistant strains.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Review
Immunology
Susanna Esposito, Giulia Chiopris, Giulia Messina, Tiziana D'Alvano, Serafina Perrone, Nicola Principi
Summary: CMV is a common cause of congenital infection and non-genetic sensorineural hearing loss in children, with up to 2% of neonates affected, particularly in developing countries. Research on a vaccine to prevent CMV infection faces challenges due to the complex relationship between the host's immune system and the virus, highlighting the need for further studies.
Article
Immunology
Marta Santos Bravo, Nicolas Plault, Sonsoles Sanchez Palomino, Maria Mar Mosquera Gutierrez, Francesc Fernandez Aviles, Maria Suarez Lledo, Nuria Sabe Fernandez, Montserrat Rovira, Sophie Alain, M. Angeles Marcos Maeso
Summary: For transplant recipients with CMV infection resistant to standard therapy, MBV could be an effective treatment option. However, the emergence of MBV resistance should be carefully monitored through clinical follow-up and genotypic and phenotypic studies.
JOURNAL OF INFECTIOUS DISEASES
(2021)
Article
Surgery
Stephanie Golob, Jaya Batra, Ersilia M. DeFilippis, Matan Uriel, Matt Carey, Maureen Gaine, Angelo Mabasa, Justin Fried, Jayant Raikelkar, Susan Restaino, Sun Hi Lee, Farhana Latif, Melana Yuzefpolskaya, Paolo C. Colombo, Jason Choe, David Majure, Douglas Jennings, Marcus R. Pereira, Kevin Clerkin, Gabriel Sayer, Nir Uriel
Summary: This study evaluated the safety and efficacy of Letermovir as a prophylactic agent for CMV in heart transplant recipients. The results showed that Letermovir is an effective alternative to valganciclovir, but close monitoring for breakthrough CMV and calcineurin inhibitor levels is necessary.
CLINICAL TRANSPLANTATION
(2022)
Article
Immunology
Lena Royston, Eva Royston, Stavroula Masouridi-Levrat, Nathalie Vernaz, Yves Chalandon, Christian Van Delden, Dionysios Neofytos
Summary: The study demonstrated that primary anti-CMV letermovir prophylaxis significantly reduced the incidence of CMV infection in high-risk patients after HCT, decreasing the need for treatment and associated costs. Letermovir also showed positive effects on platelet reconstitution and renal function.
Review
Infectious Diseases
Camille Nelson Kotton, Nassim Kamar
Summary: Cytomegalovirus (CMV) infection has a significant impact on transplant outcomes and is still prevalent in high-risk patients. Ganciclovir and valganciclovir are commonly used drugs for prevention and treatment. Letermovir has shown similar efficacy to valganciclovir but with fewer side effects. Refractory and resistant CMV can still occur, but maribavir has been effective in treating these cases with reduced toxicity. This review discusses prevention strategies, refractory and resistant CMV, drug-related side effects, and optimal use of novel anti-CMV therapies.
INFECTIOUS DISEASES AND THERAPY
(2023)
Review
Immunology
Eveline Hofmann, Daniel Sidler, Suzan Dahdal, Pascal Bittel, Franziska Suter-Riniker, Oriol Manuel, Laura N. Walti, Cedric Hirzel
Summary: Letermovir can be considered as a secondary prophylaxis option for GCV-resistant CMV in SOT recipients, but caution is warranted due to the risk of resistance development.
Two renal transplant recipients developed letermovir resistance after using it for secondary prophylaxis of GCV-resistant CMV.
Letermovir has a relatively low genetic barrier to resistance, highlighting the need for careful consideration when using it for GCV-resistant CMV infection.
TRANSPLANT INFECTIOUS DISEASE
(2021)
Article
Hematology
Ioannis Politikos, Carmen Lau, Sean M. Devlin, Sean Quach, Andrew Lin, Miguel -Angel Perales, Gunjan L. Shah, Susan K. Seo, Genovefa A. Papanicolaou, Juliet N. Barker
Summary: Letermovir prophylaxis is highly effective in reducing cytomegalovirus infection, related mortality, and treatment toxicities in cord blood transplantation recipients.
Article
Immunology
Lena Royston, Eva Royston, Stavroula Masouridi-Levrat, Yves Chalandon, Christian Van Delden, Dionysios Neofytos
Summary: In allogeneic hematopoietic cell transplant recipients, low-level CMV replication and acute gastrointestinal graft-versus-host disease are significant risk factors for breakthrough clinically significant CMV infection during letermovir prophylaxis. These findings highlight the importance of closer CMV monitoring and prompt preemptive treatment by clinicians.
IMMUNITY INFLAMMATION AND DISEASE
(2021)
Article
Immunology
Yiqi Su, Anat Stern, Eleni Karantoni, Tamara Nawar, Gyuri Han, Phaedon Zavras, Henry Dumke, Christina Cho, Roni Tamari, Brian Shaffer, Sergio Giralt, Ann Jakubowski, Miguel-Angel Perales, Genovefa Papanicolaou
Summary: The study found that letermovir prophylaxis (LET) can reduce the mortality disparity between cytomegalovirus-negative and positive hematopoietic cell transplant (HCT) recipients at 1 year after transplantation. Among all cytomegalovirus-positive recipients, LET is associated with decreased mortality, especially in T-cell depleted HCT.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Immunology
Sunwen Chou, Kening Song, Jingyang Wu, Tien Bo, Clyde Crumpacker
Summary: The study identified UL97 mutations T409M, H411Y, or C480F as conferring maribavir resistance in patients receiving maribavir therapy. The newly phenotyped mutation C480F showed high-grade maribavir resistance and low-grade ganciclovir resistance, posing challenges to treatment.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Immunology
Joseph Sassine, Fareed Khawaja, Terri Lynn Shigle, Victoria Handy, Farnaz Foolad, Samuel L. Aitken, Ying Jiang, Richard Champlin, Elizabeth Shpall, Katy Rezvani, Ella J. Ariza-Heredia, Roy F. Chemaly
Summary: Primary prophylaxis with letermovir in CMV-seropositive allogeneic HCT recipients is associated with significant reductions in refractory or resistant CMV infections, nonrelapse mortality at week 48, as well as CS-CMVi and CMV end-organ disease. This approach effectively prevents difficult-to-treat CMV infections and improves outcomes after allogeneic HCT.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Biology
Markus J. Barten, Fausto Baldanti, Alexander Staus, Christian M. Hueber, Kyriaki Glynou, Andreas Zuckermann
Summary: This meta-analysis suggests that prophylactic CMVIG treatment in solid organ transplantation patients can reduce the risk of CMV infection. This is particularly beneficial for patients at high risk of CMV infection or disease.
Article
Immunology
Paschalis Vergidis, Robin K. Avery, L. Joseph Wheat, Jennifer L. Dotson, Maha A. Assi, Smyrna A. Antoun, Kassem A. Hamoud, Steven D. Burdette, Alison G. Freifeld, David S. McKinsey, Mary E. Money, Thein Myint, David R. Andes, Cynthia A. Hoey, Daniel A. Kaul, Jana K. Dickter, David E. Liebers, Rachel A. Miller, William E. Muth, Vidhya Prakash, Frederick T. Steiner, Randall C. Walker, Chadi A. Hage
CLINICAL INFECTIOUS DISEASES
(2015)
Article
Immunology
Maha Assi, Stanley Martin, L. Joseph Wheat, Chadi Hage, Alison Freifeld, Robin Avery, John W. Baddley, Paschalis Vergidis, Rachel Miller, David Andes, Jo-Anne H. Young, Kassem Hammoud, Shirish Huprikar, David McKinsey, Thein Myint, Julia Garcia-Diaz, Eden Esguerra, E. J. Kwak, Michele Morris, Kathleen M. Mullane, Vidhya Prakash, Steven D. Burdette, Mohammad Sandid, Jana Dickter, Darin Ostrander, Smyrna Abou Antoun, Daniel R. Kaul
CLINICAL INFECTIOUS DISEASES
(2013)
Article
Immunology
Jason Chen, Justine Abella Ross, Bernard Tegtmeier, Dongyun Yang, James I. Ito, John A. Zaia, Jana K. Dickter, Ryotaro Nakamura, Sally Mokhtari, Jane Kriengkauykiat, Monzr M. Al Malki, Sanjeet S. Dadwal
TRANSPLANT INFECTIOUS DISEASE
(2020)
Article
Pharmacology & Pharmacy
Jana K. Dickter, Abigail L. Martin, Stephanie Ho, Justine A. Ross, Geoffrey P. Shouse
Summary: The study highlights that ibalizumab-uiyk can be used as bridge therapy for patients with drug-resistant HIV undergoing chemotherapy, as it has no known drug-drug interactions.
JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
(2021)
Article
Oncology
Justine Abella Ross, Kellie Komoda, Sumanta Pal, Jana Dickter, Ravi Salgia, Sanjeet Dadwal
Summary: This study retrospectively reviewed patients receiving ICIs and found that approximately 14% of patients experienced serious infections, with 25% of cases confirmed through bacterial cultures. Steroid use was the only significant risk factor associated with serious infections.
Article
Infectious Diseases
Jana K. Dickter, LiYing Cai, David S. Snyder
CASE REPORTS IN INFECTIOUS DISEASES
(2019)
