Cytomegalovirus infection in immunocompetent critically ill patients

Abstract

Both immunocompromised patients and immunocompetent critically ill patients have high risks of developing cytomegalovirus (CMV) infection. In critically ill patients, CMV infection is associated with prolonged duration of mechanical ventilation and ICU/hospital stay, and increased mortality. CMV infection in immunocompetent critically ill patients has become a hot topic; randomized clinical trials have been conducted to investigate the efficacy of antiviral therapy for preventing CMV infection in these patients. To date, antiviral prophylaxis therapy has been shown to suppress CMV reactivation, but without positive effects on clinical outcomes such as mortality rates. Anti-CMV drugs are also known for the frequent occurrence of severe side effects. Therefore, antiviral therapy has not been recommended for preventing CMV infection in immunocompetent critically ill patients. Anti-CMV drugs with reduced risks of myelosuppressive effects or renal toxicity are currently under clinical trials. It is essential to keep updated knowledge on the emerging findings regarding CMV infection in critically ill patients.