Maribavir, known as the brand name Livtencity, is a benzimidazole riboside that inhibits cytomegalovirus (CMV) pUL97 kinase used to treat refractory post-transplant CMV infections. Human cytomegalovirus is a herpesvirus that is a common infection following stem cell or organ transplants. Like other herpesviruses, it tends to presist in the host and become reactivated under immunosuppressive conditions, such as during a transplant. Maribavir competitively inhibits human CMV pUL97 viral protein kinase which plays a role in viral egress, and viral replication or regulation of hot cell cycle progression. It has been found to participate in the acquisition of tegument during virion morphogenesis. It has also been found to phosphorylate the nuclear egress complex, which allows to viral release from the host cell. It also plays a role in the phosphorylation of Lamins-A/C and DNA polymerase. Lamin-A/C contributes to viral release with the nuclear egress complex, while DNA polymerase is essential in DNA replication. The inhibition of pUL97 viral protein kinase results in a viable, but severely defective virus upon replication. The exact reasons for this remain poorly defined.

Maribavir Pathway References