Cytomegalovirus therapy: current constraints and future opportunities.

Articles published in the last year have changed perceptions of cytomegalovirus. It is now recognized as a rapidly replicating virus which develops resistance frequently during chronic administration of ganciclovir. In addition to causing end-organ diseases, it plays a causal role in the multifactorial processes leading to graft rejection after renal transplant and accelerated atherosclerosis after heart transplant. New treatments which are safe and potent are urgently needed and should be highly cost-effective when the full clinical impact of this virus is assessed.