Pharmacotherapy of Post-Transplant Viral Infections

Background: Management of a number of significant viral pathogens in transplant recipients remains challenging. Objectives: To define an optimal antiviral approach to the management of cytomegalovirus (CMV), human herpes virus-6 ( HHV-6), Epstein-Barr (EBV)-associated post- transplant lymphoproliferative disorder (PTLD), and polyoma virus- associated nephropathy in transplant recipients. Methods: Clinical trials and existing data regarding use of antiviral agents for these viruses were reviewed to develop evidence- based recommendations for their management. Conclusions: Weighing the current evidence regarding the use of valganciclovir as pre-emptive therapy or prophylaxis, the former approach offers a greater benefit for the overall prevention of CMV disease. Limited data show that prophylaxis with antiviral agents is associated with a reduction in the risk of EBV-associated PTLD. Treatment options for HHV-6 and polyoma virus-associated nephropathy are still limited