Cytomegalovirus quantification: Where to next in optimising patient management?

BackgroundOver the years quantification of cytomegalovirus (HCMV) load in blood has become a mainstay of clinical management helping direct deployment of antiviral therapy, assess response to therapy and highlight cases of drug resistance.AimsThe review focuses on a brief historical perspective of HCMV quantification and the ways in which viral load is being used to improve patient management.MethodsA review of the published literature and also personal experience at the Royal Free Hospital.ResultsQuantification of HCMV is essential for efficient patient management. The ability to use real time quantitative PCR to drive pre-emptive therapy has improved patient management after transplantation although the threshold viral loads for deployment differ between laboratories. The field would benefit from access to a universal standard for quantification.ConclusionsWe see that HCMV quantification will continue to be central to delivering individualised patient management and facilitating multicentre trials of new antiviral agents and vaccines in a variety of clinical settings.