Cytomegalovirus Reactivation in Critically Ill Immunocompetent Patients

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Abstract
Cytomegalovirus (CMV) has long been recognized as an important viral pathogen in immunocompromised hosts. In addition to direct effects of CMV due to viral replication and resultant tissue injury, a range of indirect effects have been attributed to CMV in immunocompromised patients, including increased risk of secondary bacterial and fungal infections,1-5 predisposition to specific malignancies such as Epstein-Barr virus–associated posttransplant lymphoproliferative disorder,6 cardiovascular disease,7,8 and mortality.2-5,9,10 A causal role of CMV in mediating these indirect effects is supported by studies of antiviral prophylaxis in immunosuppressed patients demonstrating reductions in secondary bacterial and fungal infections,2-5 hospitalization,11 and mortality.2-5