Prevention of cytomegalovirus disease in renal allograft recipients

Cytomegalovirus (CMV) disease in renal allograft recipients continues to cause morbidity, mortality and high medical expenses. In addition to damaging organs directly, CMV has been associated with allograft rejection, and bacterial, fungal and parasitic superinfections. Dramatic strides have been made in our efforts to prevent CMV disease. The prophylactic strategies have included passive immunization, interferon, vaccine, and antiviral agents. This article summarizes the experience to date in efforts to prevent CMV disease, emphasizing our current approach using high-dose oral acyclovir. It concludes with a review of potential future directions in prophylaxis with new antiviral agents alone or in combination.