Dr. Cecilia Söderberg from the Karolinska Institute, Sweden, gave a lecture today at the European Society for Organ Transplantation, regarding the mechanisms by which the CMV leads to its indirect effects. It has been proposed that indirect CMV effects appear as a result of the ability of the virus to influence immunological functions, and hence the virus must replicate in its host.
Viral infection of cells may lead to indirect effects and graft damage by altered expression of growth factors and cytokines, increased antigen processing and presentation associated with the major histocompatibility complex, and up-regulation of pro-inflammatory adhesion molecules in uninfected cells.
Although ganciclovir is effective for the prevention and treatment of CMV disease in transplant patients, the intravenous form is inconvinient for long-term administration and oral ganciclovir has low bioavailability. The oral pro-drug valganciclovir has higher bioavailability.
Prophylaxis is better able to reduce the overall incidences of many of the complications of CMV compared with pre-emptive treatment.
Viral infection of cells may lead to indirect effects and graft damage by altered expression of growth factors and cytokines, increased antigen processing and presentation associated with the major histocompatibility complex, and up-regulation of pro-inflammatory adhesion molecules in uninfected cells.
Although ganciclovir is effective for the prevention and treatment of CMV disease in transplant patients, the intravenous form is inconvinient for long-term administration and oral ganciclovir has low bioavailability. The oral pro-drug valganciclovir has higher bioavailability.
Prophylaxis is better able to reduce the overall incidences of many of the complications of CMV compared with pre-emptive treatment.
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