Prospects for development and potential impact of a vaccine against congenital cytomegalovirus (CMV) infection.

Arecent review made note of the 50th anniversary of the identification of human cytomegalovirus (CMV) in cell culture, an important milestone that paved the way to today’s understanding of the molecular biology, immunology, and clinical importance of this ubiquitous viral infection. In the past 50 years, much progress has been made in the characterization of disease caused by CMV. Solid organ and hematopoietic stem cell (HSC) transplant patients have significant problems with CMV disease, including pneumonia, retinitis, and graft rejection, and there are extensive efforts to identify immune correlates of protection in these populations. However, the major concern that pediatricians face with respect to CMV disease is the problem of congenital CMV infection. CMV is the most common congenital viral infection in the developed world, and disease in newborn infants is associated with mental retardation, neurodevelopmental disability, and sensorineural hearing loss (SNHL). Preconceptual maternal immunity to CMV, though imperfect, provides protection against infection and disability in newborn infants. This knowledge has driven great interest in the development of candidate CMV vaccines that could, in principle, decrease the underrecognized and underappreciated disease burden associated with this disabling infection.