Cytomegalovirus infection

The outcome of treatment for cytomegalovirus (CMV) disease is generally favourable, with the exception of CMV retinitis, which could lead to irreversible blindness, both in transplant patients and in patients with AIDS.​[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. http://www.ncbi.nlm.nih.gov/pubmed/17511815?tool=bestpractice.com [72]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. https://www.doi.org/10.1093/infdis/jiaa480 http://www.ncbi.nlm.nih.gov/pubmed/32909605?tool=bestpractice.com ​​ In donor CMV-seropositive, recipient seronegative (CMV D+/R-) solid organ transplant recipients and haematopoietic stem cell transplant recipients with graft-versus-host disease, recurrence of CMV replication is common, and repeated courses of antiviral therapy may be needed. In solid organ transplant recipients, some experts administer secondary prophylaxis in patients at high risk for recurrence (CMV D+/R-).

There is growing recognition of the long-term adverse consequences of CMV infection in transplant recipients, such as increased risk of chronic allograft failure (including accelerated vasculopathy after heart transplantation, obliterative bronchiolitis after lung transplantation, and tubulointerstitial fibrosis after kidney transplantation).

The most common long-term clinical outcome of congenital CMV disease is hearing loss.