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Antiviral drugs used as protective and preventive therapy reduce CMV disease and CMV‐associated deaths in solid organ transplant recipients

Cytomegalovirus (CMV; a herpes virus) is the most common type of virus detected in people who have received solid organ transplants (kidney, heart, liver, lung and pancreas). CMV disease is a major cause of illness and death during the first six to 12 months after transplantation. Two main strategies to prevent CMV disease have been adopted: protection and prevention (prophylaxis) of viral infections for all organ recipients using antiviral drugs, or 'pre‐emptive therapy' of organ recipients, who develop evidence of CMV infection during routine screening.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Pre‐emptive treatment with antiviral agents can help to reduce the risk of cytomegalovirus disease

Cytomegalovirus (CMV) is the most common cause of viral disease in people who have received kidney, heart, liver, lung or pancreas transplants (solid organ transplants). CMV is a major cause of illness and death during the first six months after transplantation. Characteristics of CMV include fever, very low white blood cell counts (leucopenia) and very low numbers of platelets (thrombocytopenia) with or without specific organ involvement.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antiviral medicines, interferon, and corneal surface removal in the treatment of herpes simplex virus infection of the eye

We compared different treatments of people's eyes infected with herpes simplex virus (HSV).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Prevention of transmission of cytomegalovirus from mother to fetus during pregnancy

There is insufficient evidence from randomised controlled trials to recommend use of any particular intervention to prevent the transmission of cytomegalovirus (CMV) from mother to fetus during pregnancy (congenital CMV infection). CMV is a herpesvirus and is the most common cause of congenital infection in developed countries. Some 40% of women who acquire the infection during pregnancy transmit the virus to their fetus. The fetus can have serious health problems as a result of this infection, including  growth restriction and the risk of late miscarriage. While 90% of infants with congenital CMV infection display no manifestations at birth, the remaining 10% do have signs and are at risk of life‐long neurological consequences, including cognitive and motor deficits, hearing and visual impairments. Maternal education and behavioural modification are used to limit women acquiring CMV in pregnancy (for example by improved hand hygiene). Drug interventions include antiviral treatment, immunoglobulin therapy (for example CMV hyperimmune globulin) and the possibility of anti‐CMV vaccination. There is currently no licensed vaccine against CMV. Antiviral therapy, such as ganciclovir, can be given to the newborn infant to prevent or reduce any consequences of congenital infection. Interventions differ in their efficacy, risks to the baby, possible side effects (such as nephrotoxicity, bone marrow suppression, and emergence of resistant CMV strains) and acceptability of use.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Prophylaxis with Immunoglobulin G (IgG), anti CMV vaccine or interferon do not significantly reduce CMV disease and CMV‐associated mortality in solid organ transplant recipients

Cytomegalovirus (CMV) is the most common virus causing disease and death in solid organ transplant recipients (kidney, heart, liver, lung and pancreas) during the first six months after transplantation. This review looked at the benefits and harms of IgG, anti CMV vaccines and interferon to prevent CMV disease in solid organ transplant recipients. Thirty seven studies (2185 participants) were identified. This review shows that IgG did not reduce the risk of CMV disease or all‐cause mortality compared with placebo or no treatment. The combination of IgG with antiviral medications (aciclovir or ganciclovir) were not more effective than antiviral medications alone in reducing the risk of CMV disease or all‐cause mortality. Anti CMV vaccines and interferon did not reduce the risk of CMV disease compared with placebo or no treatment. Currently there are no indications for IgG in the prevention of CMV disease in recipients of solid organ transplants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

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