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Letermovir is an antiviral medication used to prevent cytomegalovirus (CMV) infection and disease in adult recipients of allogeneic hematopoietic stem cell transplants (HSCT) and kidney transplants who are at high risk for CMV[1][2][3][5]. It is the first approved member of a new class of CMV anti-infectives known as DNA terminase complex inhibitors[3]. Letermovir acts by inhibiting the viral DNA terminase complex, specifically targeting the pUL56 subunit, which is essential for processing and packaging viral DNA into mature virions[3][6][8]. This mechanism prevents production of mature viral genomes and viable viral particles. Letermovir was developed by Merck & Co. and is marketed under the brand name Prevymis. It received FDA approval in 2017 for prophylaxis against CMV infection in transplant patients[3][5].
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