Cytomegalovirus Immune Globulin IV
Class: Antitoxins and Immune Globulins
ATC Class: J06BB09
VA Class: IM500
Brands: Cytogam
Introduction
Specific immune globulin (hyperimmune globulin). Cytomegalovirus immune globulin IV (CMV-IGIV) contains IgG prepared from plasma of adults selected for high titers of CMV antibody.
Uses for Cytomegalovirus Immune Globulin IV
Prevention of CMV Disease in Solid Organ Transplant Recipients
CMV prophylaxis in kidney transplant recipients at risk for primary CMV infection and disease (i.e., CMV-seronegative recipients of a kidney from a CMV-seropositive donor). Generally used in conjunction with an antiviral (e.g., acyclovir, ganciclovir); has been used alone.
CMV prophylaxis in liver, lung, pancreas, or heart transplant recipients. Usually used in conjunction with an antiviral (e.g., ganciclovir, acyclovir).
Optimum regimens for CMV prophylaxis based on type of organ being transplanted and degree of risk for CMV infection or disease not identified, especially for those at greatest risk (e.g., CMV-seronegative recipients of organs from CMV-seropositive donors, patients receiving muromonab-CD3 [OKT3 monoclonal antibodies] or other immunosuppressive therapy).
Prevention of CMV Disease in Bone Marrow Transplant (BMT) Recipients
Has been used in individuals undergoing allogeneic BMT in an attempt to prevent primary CMV infection in those who are CMV-seronegative prior to transplant† or to prevent or attenuate secondary CMV disease (reactivation of CMV) in individuals who are CMV-seropositive prior to transplant†.
Most effective regimen for CMV prophylaxis in allogeneic BMT patients at risk for CMV infection and disease not established; conflicting results regarding possible benefits of CMV-IGIV prophylaxis in this patient population.
Treatment of CMV Pneumonitis in Transplant Recipients
Has been used in conjunction with ganciclovir for treatment of CMV pneumonitis in allogeneic BMT recipients† or CMV pneumonitis in solid organ transplant recipients† (e.g., liver transplant patients). Additional study needed to determine whether combined ganciclovir and CMV-IGIV therapy has any effect on long-term survival rate in allogeneic BMT patients who develop CMV pneumonitis.
Do not use alone for treatment of CMV pneumonia in BMT recipients.
Congenital or Neonatal CMV Infection
Has been used in limited number of pregnant women with primary CMV infection in an attempt to treat or prevent congenital CMV infection†.
Not currently recommended for prevention of maternal-fetal transmission of CMV; additional study needed to evaluate possible benefits and risks of antenatal CMV-IGIV.
CMV Infection in HIV-Infected Individuals
Potential role, if any, for prevention or treatment of CMV infection or disease in HIV-infected individuals† not evaluated to date. Recommendations from CDC, National Institutes of Hea...
