Cytomegalovirus (CMV) is found throughout the world in all geographic and
socioeconomic groups, but, in general, it is more widespread in developing countries
and in areas of lower socioeconomic conditions. CMV still remains a major human
pathogen causing significant morbidity and mortality in immunosuppressed or
immunocompromized individuals. Between 50% and 80% of adults in the United States
are infected with CMV by 40 years of age. CMV is the most common congenitally
transmitted virus, resulting in approximately 1 in 150 children born with congenital
CMV infection, and in approximately 1 in 750 children developing permanent
disabilities due to CMV. Thus, development of vaccines against CMV infections has
been a major biomedical research priority. In this chapter, immunobiology of host-
CMV interactions is discussed as related to the host immune responses against viral
infection, providing insights into the complex interplay between host and virus that
facilitates viral persistence. In addition, an update on CMV vaccines that are currently
in preclinical and clinical development, is provided, outlining important questions about
the nature of protective immune responses that will be required for potential CMV
immunization strategies.
Keywords: Adoptive transfer, anti-viral drugs, anti-viral immune responses, cellmediated
immunity, CMV, congenital transmission, host-virus interactions,
immunocompromised, immunodominant, immunosuppression, immunization,
primary infection, prophylaxis, seropositive, symptomatic disease, T cells,
vaccines, viral clearance, viremia, virulence
