Valganciclovir to prevent or treat cytomegalovirus disease in organ transplantation

Expert Rev Anti Infect Ther. 2011 Nov;9(11):955-65. doi: 10.1586/eri.11.116.

Abstract

Cytomegalovirus (CMV) is generally considered the most significant pathogen to infect patients following organ transplantation. Significant improvements have been achieved in the management of CMV disease over recent years, especially since the introduction of oral drugs such as oral ganciclovir followed by valganciclovir (VGC), a prodrug of ganciclovir with enhanced bioavailability. Several randomized controlled trials have shown that VGC is an efficacious and convenient oral drug to prevent or treat CMV disease in solid-organ transplant recipients. In this article, we discuss the clinical and pharmacological experience with the use of VGC for the management of CMV in solid-organ transplant recipients. Finally, novel strategies to further reduce the incidence of CMV disease after transplantation are also reviewed.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Antiviral Agents / pharmacokinetics
  • Antiviral Agents / therapeutic use
  • Cytokines / biosynthesis
  • Cytomegalovirus / drug effects*
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / physiopathology
  • Cytomegalovirus Infections / prevention & control*
  • Cytomegalovirus Infections / virology
  • Drug Dosage Calculations
  • Ganciclovir / analogs & derivatives*
  • Ganciclovir / pharmacokinetics
  • Ganciclovir / therapeutic use
  • Humans
  • Immunity, Cellular / drug effects
  • Immunocompromised Host*
  • Organ Transplantation*
  • Practice Guidelines as Topic
  • Prodrugs / pharmacokinetics
  • Prodrugs / therapeutic use
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Transplantation Conditioning / adverse effects*
  • Valganciclovir
  • Viral Load / drug effects
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • Cytokines
  • Prodrugs
  • Valganciclovir
  • Ganciclovir