22
CMV Overview
▪ CMV is a member of the herpes virus family and the
largest among known human viruses
▪ Once infected, an individual carries the virus for life,
typically in a latent state
— Prevalence of infection is strongly correlated with age
— CDC estimates 50-80% infected with CMV by age 40
▪ CMV can lead to severe disease and increased mortality
in immunocompromised individuals
— High risk individuals include HSCT and SOT recipients,
as well as developing fetus or newborn children
— CMV infection can predispose patients to transplant
rejection/failure, CMV-related infections, other
opportunistic infections, and increased mortality risk
— Most common infectious complication in HSCT & SOT
▪ Current Standard of Care: moderately effective antivirals,
often associated with toxicity, resistance, delayed
immune reconstitution, late CMV and/or extended dosing
— No approved vaccine for CMV prevention or control
▪ Helocyte currently progressing novel biologic (Triplex)
— Induces CMV-specific T cell immunity to control
reactivation in post-transplant (HSCT, SOT)
▪ Triplex Advantages vs. SoC Antivirals: safety, immune
reconstitution, dosing, and no likelihood of resistance
CMV infection is ubiquitous and usually benign, but is a major cause of morbidity and mortality in immunosuppressed patients
CMV Overview Effects of CMV
CMV is easily
transmitted and is
associated with a life-
long latency…
…with the ability to
become active
(reactivation) in those
with weakened
immune systems…
…and progress to CMV
disease and create
significant risk for
morbidity and
mortality
Direct
Effects
▪ Direct clinical effects include CMV viral
syndrome and end-organ disease
▪ CMV disease: pneumonitis,
gastrointestinal disease, hepatitis,
pancreatitis, nephritis, cystitis,
myocarditis, retinitis, CNS diseases,
thrombocytopenia, hemolytic anemia,
adrenalitis, disseminated disease
▪ Indirect effects include opportunistic
infections:
— Caused by bacteria, fungi or other
virus
— More commonly, it is these indirect
effects that contribute to mortality
with CMV infection
Indirect
Effects
CMV in Hematopoietic Stem Cell & Solid Organ Transplantation
▪ CMV syndrome
▪ Tissue-invasive CMV/end-organ disease
(GI tract most common)
▪ Include graft rejection, graft failure,
opportunistic infections, atherosclerosis
and heart disease, obliterative
bronchiolitis, new onset diabetes, lung
transplantation, higher mortality