Cytomegalovirus Infection in Pediatric Immunocompromised Hosts

Abstract

Disease caused by cytomegalovirus (CMV) infection can clinically manifest in a variety of ways in the immunodeficient host and lead to significant morbidity and mortality. Infections can be primary, occur as a result of reactivation of latent virus, or infection with a new strain of CMV. Cell-mediated immunity is the main defense against CMV disease. This component of the immune system is frequently affected in children who are born prematurely, have undergone solid organ transplantation or hematopoietic stem cell transplantation, or have infection with human immunodeficiency virus. Accordingly, these children are at increased risk for severe disease due to CMV. In addition, CMV itself alters cell-mediated immunity and may predispose hosts to other bacterial, fungal, or viral infections as well as predispose to graft rejection. The importance of CMV in these special populations of children, emphasizing epidemiology, risk factors, and preventive strategies, is reviewed.

Multidrug-resistant cytomegalovirus infection in a pediatric stem cell transplantation patient

“…Cytomegalovirus (CMV) is a member of the Herpesviridae family and is characterized by a lifelong latency in the host (Russell et al, 2011). Clinical presentations of CMV infection are mainly minimal to absent in immunocompetent hosts but can lead to severe symptoms up to life-threatening conditions in immunosuppressed patients.…”

“…However, it still remains one of the major infectious complications and causes of morbidity and mortality after hematopoietic stem cell transplantation (HSCT) (Russell et al, 2011;Ljungman et al, 2011). Risk factors for CMV infection in HSCT patients include CMV seropositivity of donor and recipient, allogeneic transplantation (especially with T cell-depleted unrelated or HLA-mismatched donors) and cell source.…”

“…In HSCT patients, cellular immunity is mainly significantly impaired during the first 100 days post-transplant. CMV infection in HSCT patients manifests as enterocolitis, pneumonia, hepatitis or as retinitis and bone marrow suppression (Russell et al, 2011). Although less frequently, late CMV reactivation (>100 days posttransplant) can occur (Cervera et al, 2007;Sousa et al, 2014).…”

Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children

“…Risk factors include human immunodeficiency virus (HIV) infection and immunocompromised status after bone marrow/stem cell transplantation (BMT/SCT) and solid organ transplantation [2]. Despite being a life threatening condition, if diagnosis is made in a timely manner, CMV pneumonia can potentially be cured with appropriate antiviral therapy ( i.e.…”

Immune Protection against Virus Challenge in Aging Mice Is Not Affected by Latent Herpesviral Infections

“…he vast majority of people carry a combination of latent herpesviruses which may cause severe disease and death if they reactivate upon immune suppression (1)(2)(3)(4). It has been proposed that human cytomegalovirus (HCMV) infection may be a major environmental factor accelerating immune senescence in older people (5)(6)(7)(8)(9)(10).…”