Cytomegalovirus in children undergoing haematopoietic stem cell transplantation: a diagnostic and therapeutic approach to antiviral resistance

Jocelyn Hume; Emma L Sweeney; Kym Lowry; Chris Fraser; Julia E Clark; David M Whiley; Adam D Irwin

doi:10.3389/fped.2023.1180392

Cytomegalovirus in children undergoing haematopoietic stem cell transplantation: a diagnostic and therapeutic approach to antiviral resistance

Front Pediatr. 2023 May 30:11:1180392. doi: 10.3389/fped.2023.1180392. eCollection 2023.

Authors

Jocelyn Hume^{1

2}, Emma L Sweeney¹, Kym Lowry¹, Chris Fraser³, Julia E Clark⁴, David M Whiley^{1

2}, Adam D Irwin^{1

4}

Affiliations

¹ The University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
² Central Microbiology, Pathology Queensland, Brisbane, QLD, Australia.
³ Blood and Bone Marrow Transplant Program, Queensland Children's Hospital, Brisbane, QLD, Australia.
⁴ Infection Management and Prevention Service, Queensland Children's Hospital, Brisbane, QLD, Australia.

Abstract

Cytomegalovirus (CMV) is a ubiquitous virus which causes a mild illness in healthy individuals. In immunocompromised individuals, such as children receiving haematopoietic stem cell transplantation, CMV can reactivate, causing serious disease and increasing the risk of death. CMV can be effectively treated with antiviral drugs, but antiviral resistance is an increasingly common complication. Available therapies are associated with adverse effects such as bone marrow suppression and renal impairment, making the choice of appropriate treatment challenging. New agents are emerging and require evaluation in children to establish their role. This review will discuss established and emerging diagnostic tools and treatment options for CMV, including antiviral resistant CMV, in children undergoing haematopoietic stem cell transplant.

Keywords: antiviral resistance; cytomegalovirus; emerging therapies; haematopoietic stem cell transplant; pediatric.

Publication types

Review

Grants and funding

This work was supported by the Children's Hospital Foundation (project ID RPC00095). Our work is also supported by an Australian Research Council Hub grant for antimicrobial resistance (project ID IH190100021).