Valganciclovir for the prevention and treatment of CMV in solid organ transplant recipients.

IMPORTANCE OF THE FIELD: Cytomegalovirus (CMV) infection is the most common viral infectious complication after solid organ transplantation (SOT). Ganciclovir is the first-line anti-CMV treatment, but its low oral bioavailability limits its use and generally intravenous treatment has been mandatory. Valganciclovir is a prodrug of ganciclovir with > 60% bioavailability and has become an alternative to intravenous ganciclovir. AREAS COVERED IN THIS REVIEW: The review examines the use of valganciclovir both for prophylaxis and treatment of CMV disease in SOT. WHAT THE READER WILL GAIN: The reader will be provided an overview of the literature on valganciclovir related to efficacy and safety in SOT recipients. Furthermore, the use of valganciclovir in less well-documented areas, such as patients with potential problems with oral absorption of drugs, pediatric patients and patients with life-threatening CMV disease, is discussed. TAKE HOME MESSAGE: The major take home message is that valganciclovir is a documented option for prevention and treatment of CMV in most SOT recipients. Given the ease of use and clinical efficacy it allows for substituting intravenous treatment in the majority of cases and has resulted in a major change of therapy for CMV in solid organ transplanted patients.