Infections à cytomégalovirus humain en transplantation : diagnostic virologique et traitement antiviral

Among hematopoietic stem cell transplant recipients and solid organ transplant recipients, cytomegalovirus (CMV) infections remain an important cause of morbidity and mortality, despite the improvement of infection monitoring using DNA quantification by real-time PCR and the use of efficient antiviral drugs ([val]ganciclovir, foscarnet, cidofovir). Moreover, high immunosuppression and prolonged prophylactic or curative antiviral treatments lead to the emergence of CMV resistance. Antiviral treatment of CMV infections does not undergo a real consensus, although there are different guidelines. A better understanding of CMV resistance mutations to antivirals and the use of new antiviral drugs are warranted in order to improve therapeutic management of transplant recipients.