Acquired CMV: Risks and Treatments
Acquired CMV infection is when a person is infected with CMV after birth, whether during childhood or adulthood.
Acquired CMV is actually very common with anywhere from 50-80% of adults in the United States having been infected with CMV by the time they reach 40 years old.
However, acquired CMV can cause serious problems for people who are immunocompromised and those who have weakened immune systems, including people with:
- Organ transplants
- HIV/AIDS infection
- Medications, such as glucocorticoids, cytostatics, antibodies, or drugs acting on immunophilins
In children and adults who have organ transplants, CMV infections are linked with rejection or malfunction of the transplant.
In people who are immunocompromised, CMV can attack specific organs resulting in any of the following:
- Esophagus (CMV esophagitis)
- Stomach or intestines (CMV gastroenteritis) - Diarrhea, swallowing difficulties or pain, and ulcerations with bleeding
- Eye (CMV retinitis) - Blindness, floaters in the eye, and visual impairment
- Lung (CMV pneumonia) - Pneumonia with impaired oxygen uptake (hypoxia)
- Brain - Coma, encephalitis with behavioral changes, and seizures
For these people, CMV treatment includes both induction therapy and maintenance therapy. Induction therapy is meant to treat the disease and usually takes two or three weeks. Maintenance therapy is intended to prevent CMV from causing disease again in the future.
Some of the current treatment options for acquired CMV can include:
* Ganciclovir (Cytovene or Vitrasert) - can be given intravenously (into a vein), orally, or as a pellet implanted in the eye to treat an infection in the retina
* Valganciclovir - similar to ganciclovir, but with better oral absorption
* Cidofovir (Vistide) - approved for the treatment of CMV retinitis
* Foscarnet (Foscavir) - given intravenously, usually reserved for those who have virus that is resistant to ganciclovir or those who have serious side effects from ganciclovir
It’s important to remember that side effects of ganciclovir and valganciclovir can include the suppression of white blood cells (needed to fight infection), red blood cells (that carry oxygen), and platelets (that help the blood to clot). Additionally, cidofovir and foscarnet can cause kidney damage. These medications should only be administered under the direct care of a physician and careful and attentive monitoring should take place during treatment.
Is an acquired CMV infection causing concern for you or anyone you know? Not sure how to proceed with your acquired CMV infection? Be sure to consult with your physician and/or an infectious disease specialist for more information about your particular case of acquired CMV and what you might be able to do to help it.
Category: Awareness, "Basic Facts", Clinical