Diagnosis, Prophylaxis and Treatments of Cytomegalovirus Infection and Reactivation

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 3782

Special Issue Editor


E-Mail Website
Guest Editor
Hematopoietic Stem Cell Transplantation Unit, Department of Hematology and Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
Interests: hematopoietic stem cell transplantation; haploidentical HSCT; advanced cell therapies; inherited bone marrow failure syndromes; immunodeficiency/immune regulatory disorders; high-risk neuroblastoma

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to our Special Issue “Diagnosis, Prophylaxis and Treatments of Cytomegalovirus Infection and Reactivation”.

Cytomegalovirus (CMV) is a well-known ubiquitous herpesvirus that is highly diffused among the population with an estimated overall seroprevalence rate of over 50% that increases with age.

It is known to cause a wide range of clinical syndromes, from asymptomatic infection in most healthy hosts to severe and even fatal disease in newborns and immunocompromised individuals. Among these, hematopoietic stem cell transplantation (HSCT) recipients are the population at higher risk, in which CMV reactivation represents one of the most frequent viral complications, occurring in about 70% of CMV seropositive HSCT recipients, with rates of recurrence after a first CMV-DNAemia as high as 50–70%.

Despite the development of diagnostic approaches, with prophylaxis and pre-emptive therapy in patients at risk having contributed over the years to improved outcomes of CMV infection or reactivation, the management of CMV remains challenging.

In this Special Issue, we aim to explore current and innovative diagnostic approaches and treatment strategies whose understanding and improvement is crucial in the management and prevention of CMV-related complications.

We look forward to receiving your contributions.

Dr. Stefano Giardino
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cytomegalovirus (CMV)
  • diagnosis
  • laboratory techniques
  • molecular methods
  • new antiviral drugs
  • antiviral cell therapy

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review

11 pages, 710 KiB  
Article
Monitoring and Management of Cytomegalovirus Reactivations After Allogeneic Hematopoietic Stem Cell Transplantation in Children: Experience from a Single Pediatric Center
by Giulia Ferrando, Francesca Bagnasco, Stefano Giardino, Filomena Pierri, Sara Pestarino, Eddi Di Marco, Maria Santaniello, Elio Castagnola and Maura Faraci
Diagnostics 2024, 14(21), 2461; https://doi.org/10.3390/diagnostics14212461 - 3 Nov 2024
Viewed by 1383
Abstract
Background: CMV reactivation represents a frequent complication after HSCT. The aim of this study was to describe the incidence of CMV reactivation in a pediatric HSCT cohort and analyze the potential impact of recipient/donor-related or transplant-related factors on this complication. Furthermore, we analyzed [...] Read more.
Background: CMV reactivation represents a frequent complication after HSCT. The aim of this study was to describe the incidence of CMV reactivation in a pediatric HSCT cohort and analyze the potential impact of recipient/donor-related or transplant-related factors on this complication. Furthermore, we analyzed the management of CMV reactivation in order to purpose criteria for pre-emptive therapy. Methods: Allogeneic HSCTs, performed at IRCCS Istituto Gaslini between 2012 and 2022, were included in this analysis. CMV–DNAemia was regularly monitored. Risk stratification was based on donor/recipient serological status and additional potential risk factors were considered: haploidentical transplant; any HSCT subsequent to the first; acute and chronic GvHD; steroids; and other immunosuppressive therapies. We described also the approach for pre-emptive therapy during the period 2012–2019. Results: A total of 214 allogeneic HSCTs were performed in 189 patients. In total, 100 (46.7%) HSCTs were complicated by at least one reactivation. CMV reactivation was significantly associated with high serological risk and steroid treatment. Pre-emptive therapy was administered in 59/69 (85.5%) HSCTs during 2012–2019. In the presence of predefined risk conditions, therapy was started at a median viremia of 2050 copies/mL. No difference was observed in OS between patients with CMV reactivation versus patients who did not present this complication. Conclusions: These results suggest the potential effectiveness of the approach used in providing pre-emptive therapy based on viral load monitoring and individualized risk factors. Full article
Show Figures

Figure 1

Review

Jump to: Research

14 pages, 1414 KiB  
Review
Cytomegalovirus Infections in Hematopoietic Stem Cell Transplant: Moving Beyond Molecular Diagnostics to Immunodiagnostics
by Chhavi Gupta, Netto George Mundan, Shukla Das, Arshad Jawed, Sajad Ahmad Dar and Hamad Ghaleb Dailah
Diagnostics 2024, 14(22), 2523; https://doi.org/10.3390/diagnostics14222523 - 12 Nov 2024
Cited by 1 | Viewed by 1886
Abstract
Human CMV, regularly reactivated by simple triggers, results in asymptomatic viral shedding, powerful cellular immune responses, and memory inflation. Immunocompetent individuals benefit from a robust immune response, which aids in viral management without causing clinically significant illness; however, immunodeficient individuals are always at [...] Read more.
Human CMV, regularly reactivated by simple triggers, results in asymptomatic viral shedding, powerful cellular immune responses, and memory inflation. Immunocompetent individuals benefit from a robust immune response, which aids in viral management without causing clinically significant illness; however, immunodeficient individuals are always at a higher risk of CMV reactivation and disease. Hematopoietic stem cell transplant (HSCT) recipients are consistently at higher risk of CMV reactivation and clinically significant CMV illness due to primary disease, immunosuppression, and graft vs. host disease. Early recovery of CMV-CMI responses may mitigate effects of viral reactivation in HSCT recipients. Immune reconstitution following transplantation occurs spontaneously and is mediated initially by donor-derived T cells, followed by clonal growth of T cells produced from graft progenitors. CMV-specific immune reconstitution post-transplant is related to spontaneous clearance of CMV reactivation and may eliminate the need for prophylactic or pre-emptive medication, making it a potential predictive marker for monitoring CMV reactivation. This review highlights current thoughts and therapeutic options for CMV reactivation in HSCT, with focus on CMV immune reconstitution and post-HSCT monitoring. Immune monitoring aids in risk stratification of transplant recipients who may progress from CMV reactivation to clinically significant CMV infection. Implementing this approach in clinical practice reduces the need for periodic viral surveillance and antiviral therapy in recipients who have a high CMV-CMI and thus may experience self-limited reactivation. Therefore, in the age of precision medicine, it is critical to incorporate CMV-specific cellular immune surveillance into conventional procedures and algorithms for the management of transplant recipients. Full article
Show Figures

Figure 1

Back to TopTop