Cytomegalovirus CMV

Cytomegalovirus (CMV) is a herpesvirus, which causes an inapparent infection in immunocompetent persons. Worldwide, approximately 40% of people are infected with CMV. In immunocompromised patients, transplant recipients and neonates, CMV can cause serious and potentially lethal disease manifestations like pneumonia, retinitis and blindness, hepatitis, infections of the digestive tract, deafness or mental retardation. 

Cytomegalovirus CMV Cytoplasmic Tyrosine Kinases Cytoskeleton Cytostatic Drugs... 

Antiviral drugp interfere with viral reproduction by altering DNA synthesis. These drug are used in the treatment of herpes simplex infections of the eye, treatment in immunocompromised patients with cytomegalovirus (CMV) retinitis, and for the prevention of CMV retinitis in patients undergoing transplant. 

Cytomegalovirus (CMV) No significant reduction of the risk of CMV disease Reduced CMV viremia on IFN-a treatment Hodson et al. 2007... 

The earliest reports of neurological complications of AIDS described distal symmetrical, painful sensory neuropathy occurring in HIV patients (Snider et al. 1983). Dysimmune inflammatory polyneuropathy was subsequently recognized as a complication of AIDS (Lipkin et al. 1985). Progressive polyneuropathy associated with cytomegalovirus (CMV) infection was documented as the first truly opportunistic infection of the peripheral nerve (Eidelberg et al. 1986). 

Cytomegalovirus (CMV) Enveloped, icosahedral particles 150nm in diameter CMV is generally acquired in childhood as a subclinical infection. About 50% of adults carry the virus in a dormant state in white blood cells. The virus can cause severe disease (pneumonia, hepatitis, encephalitis) in immunocompromised patients. Primary infections during pregnancy can induce serious congenital abnormalities in the fetus... 

After T cell lysis, there is a cytokine release. Owing to this phenomenon, ATG is associated with several adverse reactions.7,8,11 The most common include fever (63%), chills (43%), headache (35%), back pain (43%), nausea (28%), diarrhea (32%), dizziness (25%), malaise (4%), and myelosuppression [leukopenia (30%) and thrombocytopenia (44%)]. Overall incidence of opportunistic infections is 27%, with cytomegalovirus (CMV) disease occurring in 11% of patients.7,8,11... 

Cytomegalovirus (CMV) disease The term used when patients who are already infected with CMV present with classic symptoms that resemble a viral infection and may include fever, malaise, arthralgias, and others. 

Cytomegalovirus (CMV) infection The term used when a patient has anti-CMV antibodies in the blood, when CMV antigens are detected in infected cells, or when the virus is isolated from a culture. 

Flood,J., et al. (1997). Diagnosis of cytomegalovirus (CMV) polyradiculopathy and documentation of in vivo anti-CMV activity in cerebrospinal fluid by using branched DNA signal amplification and antigen assays. J. Infect. Dis. 176,348-352. 

The 1,2,3-thiadiazole ring system has been incorporated into a number of compounds which have antiviral activity. The thioamide 86 is a potent inhibitor of cytomegalovirus (CMV) <2004BML3401>. 

Developed by the US company, Isis, Vitravene is used to treat cytomegalovirus (CMV) retinitis in AIDS patients. It is synthesized chemically and formulated as a sterile solution (6.6 mg active drug/ml) in WFI using a bicarbonate buffer to maintain a final product pH of 8.7. 

Cytomegalovirus (CMV) is a member of the herpes virus family, as are the varicella zoster and Epstein-Barr viruses described earlier. CMV is a common virus, and many people are infected early in the childhood. Children tend to get an asymptomatic infection, while infected young adults may develop a mono-nucleosis-like illness. Infection of a fetus is very serious and can lead to permanent brain damage or death of the fetus. In AIDS patients, CMV infection can recur and tend to infect the retinas of eyes, leading to blindness. The virus also infects the adrenal gland, leading to hormonal imbalance. CMV pneumonia in patients who have PCP at the same time is usually fatal. 

Currently, there is only one antisense drug on the market— Vitravene (active ingredient fomivirsen) for the treatment of cytomegalovirus (CMV)-induced retinitis (inflammation of the retina) in AIDS patients. Fomivirsen has 21 nucleotides complementary to a CMV mRNA sequence, which is necessary for the production of infectious virus. Two examples of experimental antisense drugs are provided in Exhibit 3.15, while Table 3.1 lists other antisense drugs in clinical phase. 

However, the nucleoside analogue 164 was found to be devoid of activity against HSV-1, HSV-2, VZV and the cytomegalovirus (CMV) in human fibroblast (MRC-5) cells. In this case the decreased conformational flexibility resulting from the introduction of the cyclopropyl group into 164 appeared to be unfavourable for interaction with the enzymes involved (vide supra. Sect. 2.9) [222]. Likewise, the cyclopropylpyrimidine 166c-f and 167, the cyclopropyl-purine nucleosides 168 showed no antiviral activity against HSV-1, HSV-2, HCMV and HIV-1 in cell culture, Eq. (66) [223]. 

Cytomegalovirus (CMV) retinitis Treatment of CMV retinitis in patients with AIDS. Combination Combination therapy with ganciclovir for patients who have relapsed after monotherapy with either drug. 

Ganciclovir IV is indicated for use only in the treatment of cytomegalovirus (CMV) retinitis in immunocompromised patients and for the prevention of CMV disease in transplant patients at risk for CMV disease. 

Antimicrobial prophylaxis Cases of Pneumocystis carinii pneumonia (PCP) have been reported in patients not receiving antimicrobial prophylaxis. Therefore, administer antimicrobial prophylaxis for PCP for 1 year following transplantation. Cytomegalovirus (CMV) prophylaxis is recommended for 3 months after transplantation, particularly for patients at increased risk for CMV disease. 

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