Cytomegalovirus Prevention in Critically Ill Patients

Approximately 50% to 60% of the North American population is infected with cytomegalovirus (CMV), a DNA herpesvirus that establishes lifelong latency in various cell types. For the vast majority of the population, the virus is maintained in latency through T-cell control although other cell types such as natural killer cells, monocytes, and macrophages also play a role. Thus, for a healthy immunocompetent individual, there is minimal long-term consequence of infection outside of certain settings, such as congenital CMV. In transplantation, including solid organ and hematopoietic stem cell, CMV is the most common opportunistic infection and can be acquired through primary infection from the donor allograft or from reactivation of endogenous latent virus.