Valganciclovir for cytomegalovirus prevention and treatment

Atul Humar

Cytomegalovirus (CMV) continues to be an important cause of significant disease in various groups of immunocompromised hosts included organ and hematopoietic stem cell transplant recipients and AIDS patients. Therapeutic and preventative strategies have been used in these patients to improve overall outcomes. Ganciclovir has traditionally been the first line drug for treatment and prevention of CMV. Valganciclovir is a prodrug of ganciclovir with enhanced oral bioavailability. Studies have shown that it is effective for the prevention of CMV disease in high-risk (donor seropositive/recipient seronegative) solid organ transplant recipients. It is also as effective as intravenous ganciclovir for the treatment of CMV retinitis in AIDS patients. The side effect profile is similar to ganciclovir. Treatment studies in solid organ transplant recipients, evaluation in pediatric patients, and prevention studies in stem cell recipients are ongoing and will help define the full role of valganciclovir in immunocompromised hosts.