Harnessing virus-specific T cells: expanding therapeutic strategies across diverse populations

Adoptive transfer of virus-specific T cells (VSTs) has been used for managing viral diseases in immunocompromised patients, including those undergoing hematopoietic stem cell transplantation and solid organ transplantation. Clinical trials targeting viruses such as cytomegalovirus, Epstein-Barr virus, adenovirus, and BK virus have demonstrated effective viral control without the toxicities associated with conventional antiviral therapies. This review explores the manufacturing, feasibility, safety, and efficacy of VSTs, complemented by 2 case studies illustrating their real-world application. We examine recent advancements in VST manufacturing that broaden their accessibility and applicability to a wider range of viral infections and immunocompromised populations. Key safety considerations, including cytokine release syndrome and graft-versus-host disease, are discussed. Lastly, we assess the expanding applications of VSTs against emerging viral targets, such as COVID-19, and address current barriers to their implementation beyond the research setting.