Multidrug Resistance in Human Cytomegalovirus

Abstract

Human cytomegalovirus (HCMV) is a member of the Herpesviridae family and infects the majority of the human population. In developed countries, seroprevalance rates are approx 60%; in developing countries, seroprevalance increases to between 90 and 100%. In common with other members of the herpesvirus family, following initial infection, the virus can remain latent within the human host and be subject to reactivations under appropriate conditions (1,2). In the immunocompetent host, HCMV rarely causes significant problems, although primary infection has been associated with hepatitis and a mononucleosislike syndrome. However, in the individual whose immune system is immature, such as the neonate or the patient receiving immunosuppressive drugs (e.g., as a transplant recipient or for human immunodeficiency virus [HIV] infection), the virus can assert its full pathogenic potential. Thus, in the neonate, congenital CMV infection is a major cause of mental retardation and sensory-neural hearing loss. In the individual with HIV, HCMV causes retinitis, gastrointestinal tract disease, and central and peripheral nervous system disorders (encephalitis and polyradiculopathy, respectively). In the transplant recipient, the virus can cause a number of symptoms, including pneumonitis, hepatitis, gastrointestinal tract disease, or prolonged pyrexial debilitating disease. Infection has been associated with organ rejection (3,4).