Summary
With the exception of congenitally-infected infants, cytomegalovirus infection is generally benign in persons with normal host defenses. In contrast, among immunosuppressed patients, these infections may be severe and sometimes fatal. Treatment of cytomegalovirus infection with presently available antiviral agents including interferons has not been successful. Prevention of infection has been successful in several circumstances, however. Cytomegalovirus is transmitted by blood products from seropositive donors, and screening to remove seropositive blood products or freezing to destroy leukocytes has been effective among neonates, cardiac transplant patients and renal dialysis patients. An alternative approach used among marrow transplant patients is passive immunization of seronegative patients with plasma or globulins with high antibody titers against cytomegalovirus. Alpha interferon given prophylactically has been effective in delaying virus reactivation and reducing the severity of infection among seropositive renal transplant patients. All of these approaches, as well as the continued development of more effective antiviral agents, will be needed for control of cytomegalovirus infection.
Zusammenfassung
Bei Personen mit normaler körpereigener Abwehr nimmt die Cytomegalovirus-Infektion im allgemeinen einen benignen Verlauf — ausgenommen Säuglinge mit konnataler Infektion. Bei immunsupprimierten Patienten ist der Verlauf hingegen schwer, manchmal tödlich. Die Therapie der Cytomegalovirus-Infektion war bisher mit den derzeit verfügbaren antiviralen Substanzen einschließlich der Interferone nicht erfolgreich. Durch verschiedene Maßnahmen gelang es jedoch, die Infektion zu verhüten. Cytomegalovirus wird durch das Blut von seropositiven Spendern übertragen. Das Screening zur Aussonderung seropositiver Blutprodukte und Gefrieren der Blutprodukte zur Zerstörung der Leukozyten waren bei Neugeborenen, Herztransplantat-Empfängern und Hämodialyse-Patienten wirksam. Bei Knochenmarkstransplantat-Empfängern wurde als Alternative die passive Immunisierung seronegativer Patienten mit Plasma oder Globulinen mit hohen Antikörpertitern gegen Cytomegalovirus eingesetzt. Prophylaktische Gabe von alpha-Interferon verzögerte die Virus-Reaktivierung und verminderte bei seropositiven Nierentransplantat-Empfängern die Schwere der Infektion. Um die Cytomegalovirus-Infektion unter Kontrolle zu bringen, wird es nötig sein, alle diese Methoden einzusetzen und weiterhin an der Entwicklung wirksamer antiviraler Substanzen zu arbeiten.
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Meyers, J.D. Prevention and treatment of cytomegalovirus infections with interferons and immune globulins. Infection 12, 143–150 (1984). https://doi.org/10.1007/BF01641701
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DOI: https://doi.org/10.1007/BF01641701