Investigational Antiviral Maribavir as Effective as Valganciclovir in Transplant Recipients with Low-Level Cytomegalovirus Viremia

One option to manage cytomegalovirus (CMV) after solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT) is preemptive therapy, in which CMV viral loads are measured and an antiviral is started when a threshold value is reached. However, of the available anti-CMV agents for preemptive therapy valganciclovir has considerable hematologic toxicity and foscarnet is available only intravenously and is nephrotoxic. Now, investigators report on a phase 2, manufacturer-sponsored trial comparing the investigational antiviral drug maribavir with valganciclovir. They enrolled HSCT or SOT recipients with CMV viral loads between 1000 and 100,000 copies/mL and no CMV disease or resistance in a 1:1:1:1 fashion to three doses of…