Indirect effects of cytomegalovirus infection in solid organ transplant recipients.

Cytomegalovirus (CMV) infection is an important and frequent complication in solid organ transplant (SOT) recipients. This infection causes direct effects by viral inclusion in the cells of various tissues, as well as indirect effects by interaction between low levels of viremia and the host immune response. These indirect effects, such as increased incidence of graft rejection and opportunistic infections or decreased recipient survival, can be as severe as the direct effects, and thus require implementation of preventative practice guidelines. Universal prophylaxis against CMV has shown to be effective for preventing CMV disease and asymptomatic CMV replication, and can be considered the treatment of choice for preventing the indirect effects of this infection.