scholarly journals The association between maternal cytomegalovirus urinary excretion and congenital infection rate

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rita Zlatkin ◽  
Efraim Bilavsky ◽  
Joseph Pardo ◽  
Lina Salman ◽  
Ron Bardin ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Infection Rate ◽  
Medical Center ◽  
Congenital Infection ◽  
Disease Rate ◽  
Cmv Infection ◽  
Non Invasive ◽  
Disease Rates ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Abstract Background In utero Cytomegalovirus (CMV) vertical transmission occurs predominantly during primary maternal infection. There are no known non-invasive methods for diagnosis of fetal infection before delivery, however some risk factors have been suggested. We aimed to evaluate the association between maternal CMV urinary excretion and congenital CMV infection. Methods A retrospective cohort study of all women who were diagnosed with primary CMV infection during pregnancy in a single university affiliated tertiary medical center, between 2012 and 2016. We examined congenital CMV infection and disease rates among infants born to women with and without CMV urinary excretion. Results Overall, 126 women were included, 77 in the positive urinary excretion group, and 49 in the negative urinary excretion group. There was no difference in maternal symptoms between the groups. We found no difference in congenital CMV infection and disease rates between infants born to women with and without urinary excretion of CMV (congenital infection rate 37.1% vs. 24.4%, p = 0.209, congenital disease rate of 18.2% vs. 22.4%, p = 0.648). Women with positive urinary CMV excretion had lower IgG avidity values (36.7% vs 54.6%, p = 0.007), with no additional difference in serology pattern. Compared to asymptomatic women, those with CMV related symptoms did not have significantly higher rates of urinary excretion of CMV (70% vs. 60.5%, p = 0.38) or congenital infection rates (40.7% vs. 31.2%, p = 0.48). Conclusion Among infants of women with primary CMV infection in pregnancy, we did not find an association between urinary excretion of CMV and congenital CMV infection.

scholarly journals The Association Between Maternal Cytomegalovirus Urinary Excretion and Congenital Infection Rate

2021 ◽  
Author(s):  
Rita Zlatkin ◽  
Efraim Bilavsky ◽  
Joseph Pardo ◽  
Lina Salman ◽  
Ron Bardin ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Infection Rate ◽  
Medical Center ◽  
Congenital Infection ◽  
Disease Rate ◽  
Cmv Infection ◽  
Non Invasive ◽  
Disease Rates ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Abstract Background: Cytomegalovirus (CMV) vertical transmission occurs predominantly during primary maternal infection. There are no known non-invasive methods for diagnosis of fetal infection before delivery, however some risk factors have been suggested. We aimed to evaluate the association between maternal CMV urinary excretion and congenital CMV infection.Methods: A retrospective cohort study of all women who were diagnosed with primary CMV infection during pregnancy in a single university affiliated tertiary medical center, between 2012 and 2016. We examined congenital CMV infection and disease rates in women with and without CMV urinary excretion.Results: Overall, 126 women were included. There was no difference in maternal symptoms between the groups. We found no difference in congenital CMV infection and disease rates between women with and without urinary excretion of CMV (congenital infection rate 37.1% vs. 24.4%, p=0.209, congenital disease rate of 18.2% vs. 22.4%, p=0.648). Women with positive urinary CMV excretion had lower IgG avidity (36.7% vs 54.6%, p=0.007), with no additional difference in serology pattern. Compared to asymptomatic women, those with CMV related symptoms did not have significantly higher rates of urinary excretion of CMV (70% vs. 60.5%, p=0.38) or congenital infection rates (40.7% vs. 31.2%, p=0.48)Conclusion: Among women with primary CMV infection in pregnancy, we did not find an association between urinary excretion of CMV and congenital CMV infection.

scholarly journals Recurrent maternal CMV infection associated with symptomatic congenital infection: results from a questionnaire study in Portugal

2019 ◽  
Vol 3 (1) ◽  
pp. e000455
Author(s):  
Paulo Paixão ◽  
Maria João Brito ◽  
Daniel Virella ◽  
Maria Teresa Neto
Keyword(s):  
Primary Infection ◽  
Recurrent Infection ◽  
Congenital Infection ◽  
High Avidity ◽  
Maternal Infection ◽  
Cmv Infection ◽  
Congenital Cmv Infection ◽  
Missed Diagnosis ◽  
Congenital Cmv

ObjectiveHuman cytomegalovirus (CMV) is the most widespread agent of congenital infection in humans and is still a challenging issue. Despite lower rates of vertical transmission being associated with recurrent infection when compared with primary infection, the first still represents the majority of congenital infections worldwide. Based on data from active reporting, we explored the influence of maternal primary/non-primary infection both on the presentation and outcome of congenital CMV infection in early childhood.DesignInfants with positive viruria during the first 3 weeks of life were reported through the Portuguese Paediatric Surveillance Unit.PatientsInfants born between 2006 and 2011 with confirmed congenital CMV infection.MethodsMaternal infection was considered primary if CMV IgG seroconversion occurred during pregnancy or low avidity IgG was documented; it was considered non-primary if positive IgG was documented before pregnancy or high avidity CMV IgG was present early in pregnancy. Follow-up questionnaires were sent up to 6 years of age.ResultsForty confirmed cases of congenital CMV infection were reported (6.6:105 live births, 95% CI 4.81 to 8.92); 22 out of 40 were asymptomatic. The odds for non-primary maternal infection if the offspring was symptomatic at birth were 6.2 (95% CI 1.2 to 32.27).ConclusionThe reported number of confirmed cases of congenital CMV infection was much lower than expected. Under-reporting and missed diagnosis were considered possible reasons. Non-primary maternal infections were associated with symptomatic congenital CMV infection in the offspring. Maternal recurrent infections can have a significant impact on the total number of symptomatic infections in Portugal.

scholarly journals Intra-uterine transmission of cytomegalovirus in women known to be immune before conception

1984 ◽  
Vol 92 (1) ◽  
pp. 89-95 ◽  
Author(s):  
P. D. Griffiths ◽  
C. Baboonian
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Congenital Infection ◽  
Infected Child ◽  
Cmv Infection ◽  
Previous Pregnancy ◽  
Congenital Cmv Infection ◽  
Retrospective Testing ◽  
A Prospective Study ◽  
Congenital Cmv

SUMMARYA prospective study identified 785 pregnant women who had been shown to possess complement fixing antibodies against cytomegalovirus (CMV) during a previous pregnancy. As these women were thus known to have been immune prior to their subsequent conception, their neonates were examined for evidence of congenital CMV infection. Specimens were obtained from 725(92%) of the neonatcs and congenital infection was found in only one (0·14%). The elder sister of the infected child was also shown, by retrospective testing of her stored cord serum for specific IgM antibodies, to have been infected in utero. Thus, one woman was identified who had delivered consecutive siblings congenitally infected with CMV. We conclude that some women have a propensity for intra-uterine transmission of CMV, despite being immune prior to conception, and speculate that such women may have acquired their infections perinatally.

scholarly journals A Novel Non-Replication-Competent Cytomegalovirus Capsid Mutant Vaccine Strategy Is Effective in Reducing Congenital Infection

2016 ◽  
Vol 90 (17) ◽  
pp. 7902-7919 ◽  
Author(s):  
K. Yeon Choi ◽  
Matthew Root ◽  
Alistair McGregor
Keyword(s):  
Guinea Pig ◽  
Small Animal ◽  
Congenital Infection ◽  
T Cell Response ◽  
Control Group ◽  
Cmv Infection ◽  
Vaccine Strategy ◽  
Congenital Cmv Infection ◽  
Guinea Pig Cytomegalovirus ◽  
Congenital Cmv

ABSTRACTCongenital cytomegalovirus (CMV) infection is a leading cause of mental retardation and deafness in newborns. The guinea pig is the only small animal model for congenital CMV infection. A novel CMV vaccine was investigated as an intervention strategy against congenital guinea pig cytomegalovirus (GPCMV) infection. In thisdisabledinfectioussingle-cycle (DISC) vaccine strategy, a GPCMV mutant virus was used that lacked the ability to express an essential capsid gene (theUL85homologGP85) except when grown on a complementing cell line. In vaccinated animals, the GP85 mutant virus (GP85 DISC) induced an antibody response to important glycoprotein complexes considered neutralizing target antigens (gB, gH/gL/gO, and gM/gN). The vaccine also generated a T cell response to the pp65 homolog (GP83), determined via a newly established guinea pig gamma interferon enzyme-linked immunosorbent spot assay. In a congenital infection protection study, GP85 DISC-vaccinated animals and a nonvaccinated control group were challenged during pregnancy with wild-type GPCMV (105PFU). The pregnant animals carried the pups to term, and viral loads in target organs of pups were analyzed. Based on live pup births in the vaccinated and control groups (94.1% versus 63.6%), the vaccine was successful in reducing mortality (P= 0.0002). Additionally, pups from the vaccinated group had reduced CMV transmission, with 23.5% infected target organs versus 75.9% in the control group. Overall, these preliminary studies indicate that a DISC CMV vaccine strategy has the ability to induce an immune response similar to that of natural virus infection but has the increased safety of a non-replication-competent virus, which makes this approach attractive as a CMV vaccine strategy.IMPORTANCECongenital CMV infection is a leading cause of mental retardation and deafness in newborns. An effective vaccine against CMV remains an elusive goal despite over 50 years of CMV research. The guinea pig, with a placenta structure similar to that in humans, is the only small animal model for congenital CMV infection and recapitulates disease symptoms (e.g., deafness) in newborn pups. In this report, a novel vaccine strategy against congenital guinea pig cytomegalovirus (GPCMV) infection was developed, characterized, and tested for efficacy. Thisdisabledinfectioussingle-cycle (DISC) vaccine strategy induced a neutralizing antibody or a T cell response to important target antigens. In a congenital infection protection study, animals were protected against CMV in comparison to the nonvaccinated group (52% reduction of transmission). This novel vaccine was more effective than previously tested gB-based vaccines and most other strategies involving live virus vaccines. Overall, the DISC vaccine is a safe and promising approach against congenital CMV infection.

Early high CMV seroprevalence in pregnant women from a population with a high rate of congenital infection

2012 ◽  
Vol 141 (10) ◽  
pp. 2187-2191 ◽  
Author(s):  
A. Y. YAMAMOTO ◽  
R. A. C. CASTELLUCCI ◽  
D. C. ARAGON ◽  
M. M. MUSSI-PINHATA
Keyword(s):  
Pregnant Women ◽  
Primary Infection ◽  
Congenital Infection ◽  
High Rate ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus ◽  
Younger Age ◽  
Congenital Cmv Infection ◽  
Stratified Sample ◽  
Congenital Cmv

SUMMARYCongenital cytomegalovirus (CMV) infection rates increase with maternal seroprevalence due to transmission from maternal non-primary infection. CMV seroprevalence estimates of pregnant women are needed for planning strategies against congenital CMV transmission. We aimed to determine the age-specific prevalence of serum antibodies for CMV in a representative age-stratified sample of unselected pregnant women from a Brazilian population. A total of 985 pregnant women, aged 12–46 years (median 24 years), were enrolled. Overall CMV seroprevalence was 97% (95% confidence interval 95·8–98·0), with age-specific (years) prevalence as follows: 12–19 (96·3%), 20–24 (97·7%), 25–29 (97·1%), and 30–46 (96·7%). CMV seroprevalence is almost universal (97%) and is found at similar levels in pregnant women of ages ranging from 12 to 46 years. Because high CMV seroprevalence is found even in women of a younger age in this population, this finding suggests that the majority of primary CMV infections occur early, in infancy or childhood. As a consequence, vaccines currently under development to prevent primary infection may not be a solution for the prevention of congenital CMV infection in this population.

Vaccination for cytomegalovirus: when, where and how

2015 ◽  
Vol 36 (4) ◽  
pp. 175
Author(s):  
Vijayendra Dasari ◽  
Rajiv Khanna
Keyword(s):  
Congenital Infection ◽  
Neurological Complications ◽  
Medical Attention ◽  
Transplacental Transmission ◽  
Cmv Infection ◽  
Seizure Disorders ◽  
Congenital Cmv Infection ◽  
Preclinical And Clinical Studies ◽  
Cmv Disease ◽  
Congenital Cmv

Although following primary human cytomegalovirus (CMV) infection in many individuals no overt symptoms are observed, CMV came to medical attention due to its significant morbidity and mortality associated with congenital infection and immunosuppressed individuals. Congenital infection occurs following transplacental transmission during pregnancy as a result of primary infection, reactivation or re-infection with a different isolate. Estimates suggest at least a million cases of congenital CMV occur annually worldwide. Congenital infection is a leading cause of neurological complications such as mental retardation, cerebral palsy, developmental delay and seizure disorders and also causes permanent disabilities, such as hearing loss and vision impairment. In addition, other common manifestation of CMV infection are stillbirth, preterm delivery and intrauterine growth restriction (IUGR) and cardiovascular disease, which are risk factors for perinatal and lifetime morbidity. Recent reports have estimated that the economic costs to public health and families due to congenital CMV infection are immense, with direct annual costs of billions of dollars. An effective CMV vaccine that could prevent transplacental transmission, reduce CMV disease and CMV-associated stillbirths has been recognised as an urgent medical need. Over the past 40 years several CMV vaccine candidates have been evaluated in a series of clinical trials and found to be effective in preclinical and clinical studies. However, in spite of extensive efforts over many decades, successful licensure of an effective CMV vaccine formulation to prevent congenital CMV infection remains elusive.

The IgG avidity value for the prediction of congenital cytomegalovirus infection in a prospective cohort study

2014 ◽  
Vol 42 (6) ◽  
Author(s):  
Yasuhiko Ebina ◽  
Toshio Minematsu ◽  
Ayako Sonoyama ◽  
Ichiro Morioka ◽  
Naoki Inoue ◽  
...  
Keyword(s):  
Cohort Study ◽  
Predictive Value ◽  
Congenital Infection ◽  
Cmv Infection ◽  
Avidity Index ◽  
Infection Group ◽  
Cutoff Value ◽  
Igg Avidity ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

AbstractCytomegalovirus (CMV) causes congenital infection with high mortality and morbidity rates in affected neonates.To evaluate the maternal IgG avidity value for the prediction of congenital CMV infection.The serum IgG avidity in all mothers was measured, and the urine of their neonates was assessed for CMV DNA in a prospective cohort study.Of 759 women with a positive test for CMV IgG, 14 had congenital CMV infection. CMV IgG avidity indices in the congenital infection group (median 35.1%) were significantly lower than those in the non-congenital infection group (70.4%). A cutoff value of <40% IgG avidity index with 96.1% specificity and 64.3% sensitivity for congenital infection was determined by receiver operating characteristic curve analyses. The highest sensitivity (88.9%), 96.2% specificity, 27.6% positive predictive value, 99.8% negative predictive value, and 96.1% accuracy were found when IgG avidity was measured in <28 weeks of gestation.The IgG avidity measurement with a cutoff value of <40% IgG avidity index might be helpful in predicting congenital CMV infection, especially in <28 weeks of gestation.

scholarly journals Birth Prevalence of Congenital Cytomegalovirus (CMV) infection in a cohort of pregnant women in Bangladesh

2018 ◽  
Vol 43 (2) ◽  
pp. 77-81
Author(s):  
Munira Jahan ◽  
Nahida Sultana ◽  
Ridwana Asma ◽  
Shahina Tabassum ◽  
Md. Nazrul Islam
Keyword(s):  
Pregnant Women ◽  
Viral Infections ◽  
Congenital Infection ◽  
High Seroprevalence ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus ◽  
Birth Prevalence ◽  
Congenital Cmv Infection ◽  
Cmv Reactivation ◽  
Congenital Cmv

Cytomegalovirus (CMV) is a frequent cause of congenital infection in humans in all regions of the world. In contrast to most congenital viral infections, congenital CMV infection and disease have been consistently demonstrated in populations with a high seroprevalence. Three hundred pregnant women were studied prospectively in their 1st, 2nd and 3rd trimester to determine the seroprevalence and seroconversion of CMV in pregnancy. After birth, babies were also tested for anti CMV IgM to determine the rate of birth prevalence. Anti CMV IgG and IgM tests were performed by chemiluminescence methods. All 300 (100%) pregnant women were anti CMV IgG positive and 180 (60%) were subsequently anti CMV IgM positive during different trimesters of pregnancy. Birth prevalence of CMV IgM antibody was 1.3% among babies of anti CMV IgM positive mothers whereas none in CMV IgM negative mothers (OR 1.01, 95% CI .996-1.027).It may be concluded that CMV IgG seroprevalence is high among Bangladeshi pregnant women and the rate of CMV reactivation is also high during pregnancy. Despite protection by maternal immunity a certain percent of babies acquire congenital CMV infection.

scholarly journals 1140. Awareness of Cytomegalovirus (CMV) Among Postpartum Mothers: Education Needed!

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S598-S598
Author(s):  
Cory T Hanlon ◽  
Alexandra K Medoro ◽  
Pablo J Sanchez ◽  
Demi R Beckford ◽  
Sydney Schoenbeck ◽  
...  
Keyword(s):  
Prior Knowledge ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Postpartum Women ◽  
Cmv Infection ◽  
Congenital Cmv Infection ◽  
The Ohio State University ◽  
Postpartum Mothers ◽  
Congenital Cmv

Abstract Background Congenital cytomegalovirus (cCMV) infection is the leading cause of non-genetic sensorineural hearing loss and affects approximately 0.5%-1% of all live births in the United States. Despite its substantial burden, maternal awareness of congenital CMV disease is limited. In addition, there is no information on CMV awareness among postpartum women who ultimately would consent for CMV newborn screening. Thus our objective of this study was to determine the proportion and characteristics of postpartum women who had knowledge of CMV in an academic medical center in Columbus, OH. Methods From May - December 2019, 276 postpartum women who delivered a newborn at the Ohio State University Wexner Medical Center, Columbus, OH were asked if they had prior knowledge of CMV. Eligible mothers had delivered an infant who was admitted to the Newborn Nursery, were ≥ 35 weeks’ gestational age, and had no signs of congenital CMV infection. These mothers had consented for enrollment of their newborn into the University of Alabama’s Collaborative Antiviral Study Group multicenter study on CMV screening (saliva) of asymptomatic infants. Pertinent demographic and clinical data were collected and subsequently managed using REDCap electronic data capture tools hosted at Nationwide Children’s Hospital, Columbus, OH. Statistical analyses were performed using GraphPad Prism. Results 505 eligible infants were born during the study period and 276 (55%) of the mothers were asked about their awareness of CMV infection. Of the 276 mothers (62%, white; 24%, Black; 3%, Asian; 0.4%, Native Hawaiian or Pacific Islander; 3%, biracial; 8%, not known), 30 (10%) had prior knowledge of CMV. Mothers who were aware of CMV did not differ from mothers who did not know about CMV in primigravida status (12/30 [40%] vs. 84/246 [34%], P=.55) or age (median, IQR; 33 years [29-35] vs. 31 years [26-34], P=.11). All infants had a normal physical examination, and none had congenital CMV infection. Conclusion Among postpartum mothers who consented to saliva screening of their newborns for congenital CMV infection, only 10% were previously aware of CMV. Such a knowledge gap should be addressed to better inform both universal and targeted newborn CMV screening among postpartum mothers. Disclosures All Authors: No reported disclosures

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