Advances in the treatment of cytomegalovirus

BackgroundHuman cytomegalovirus (HCMV) is a threat to immunologically weak patients. HCMV cannot yet be eliminated with a vaccine, despite recent advances.Sources of dataSources of data are recently published research papers and reviews about HCMV treatments.Areas of agreementCurrent antivirals target the UL54 DNA polymerase and are limited by nephrotoxicity and viral resistance. Promisingly, letermovir targets the HCMV terminase complex and has been recently approved by the FDA and EMA.Areas of controversyShould we screen newborns for HCMV, and use antivirals to treat sensorineural hearing loss after congenital HCMV infection?Growing pointsGrowing points are developing drugs against latently infected cells. In addition to small molecule inhibitors, a chemokine-based fusion toxin protein, F49A-FTP, has shown promise in killing both lytically and latently infected cells.Areas timely for developing researchWe need to understand what immune responses are required to control HCMV, and how best to raise these immune responses with a vaccine.