Cytomegalovirus

Abstract

Human cytomegalovirus (CMV), also known as heterophil-negative mononucleosis, is a ubiquitous herpesvirus that is acquired throughout life and is common in the general population. In the United States, seroprevalence rates are 40% in adolescents and up to 60–100% in adults. The higher seroprevalence seen in adults is attributable to viral reactivation that can occur later in adult life. Increased infection develops perinatally via breast milk, in day care exposure, and then during reproductive age, related to sexual activity. Other routes of transmission include blood transfusions and organ transplantation such as bone marrow, kidney, liver, heart, and/or lung. Primary infection is usually asymptomatic in young, healthy adults but may be associated with a transient mononucleosis-like syndrome. CMV infection results in major neurologic disability, morbidity, and mortality in the setting of immunosuppression such as transplant recipients, in persons with acquired immunodeficiency syndrome, and hematologic malignant neoplasms.