Cytomegalovirus (CMV) Urinary Excretion and Long-Term Outcome in Children with Congenital CMV Infection

Background and Objectives: Cytomegalovirus (CMV) constitutes the most common viral cause of congenital infections in newborns worldwide. There are a significant number of asymptomatic newborns with congenital CMV infection in Iran, which may develop long-term sequelae of infection. Unfortunately, limited data exsists from Iran on the rate of congenital CMV infection among neonates. The current study was aimed to investigate the prevalence of congenital CMV infection among Iranian neonates by testing Guthrie cards. Materials and Methods: Guthrie cards were collected from infants within 2 weeks of life, and total DNA was extracted from samples by thermal shock and evaluated for CMV DNA using nested-PCR assay. CMV infection in newborns was confirmed through a commercial CMV PCR kit. Infected infants underwent further evaluation at the hospital. Results: CMV infection was identified in four of 1174 infants (0.34%) which is approximately 3 cases per 1000 live births. Infected infants were asymptomatic at birth and had a normal hearing status similar to other children. There were no factors in relation with CMV infection among newborns. Conclusion: According to the results of this study, infected infants with congenital CMV infection could identify at early stage by testing Guthrie cards (within 21 days of life). Furthermore, since there is a lack of CMV knowledge in our popula- tion, educating and effective counseling by obstetricians/ gynecologists to the pregnant women are recommended.

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The Association Between Maternal Cytomegalovirus Urinary Excretion and Congenital Infection Rate

10.21203/rs.3.rs-143971/v1 ◽

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.

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The association between maternal cytomegalovirus urinary excretion and congenital infection rate

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04194-6 ◽

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.

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Cytomegalovirus urinary excretion and long term outcome in children with congenital cytomegalovirus infection

The Pediatric Infectious Disease Journal ◽

10.1097/00006454-200006000-00003 ◽

2000 ◽

Vol 19 (6) ◽

pp. 505-510 ◽

Cited By ~ 93

Author(s):

DANIEL E. NOYOLA ◽

GAIL J. DEMMLER ◽

DANIEL W. WILLIAMSON ◽

CAROL GRIESSER ◽

SHERRY SELLERS ◽

...

Keyword(s):

Urinary Excretion ◽

Cytomegalovirus Infection ◽

Congenital Cytomegalovirus Infection ◽

Term Outcome ◽

Long Term Outcome ◽

Congenital Cytomegalovirus

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Urinary Excretion of N1-Methylnicotinamide and N1-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients

Nutrients ◽

10.3390/nu12072059 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2059 ◽

Cited By ~ 1

Author(s):

Carolien P.J. Deen ◽

Anna van der Veen ◽

António W. Gomes-Neto ◽

Johanna M. Geleijnse ◽

Karin J. Borgonjen-van den Berg ◽

...

Keyword(s):

Urinary Excretion ◽

Kidney Transplant ◽

Premature Mortality ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Term Outcome ◽

Long Term Outcome ◽

Negatively Associated ◽

All Cause Mortality

It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of N1-methylnicotinamide (N1-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of N1-MN to N1-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both N1-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of N1-MN and 2Py (N1-MN + 2Py), and its associations with risk of premature mortality in KTR. N1-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of N1-MN + 2Py excretion were investigated with Cox regression analyses. Median N1-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. N1-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; p < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; p = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of N1-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of N1-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR.

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Comparison of Clinical and Neuroimaging Characteristics of Congenital and Possible Congenital Cytomegalovirus Infected Infants: A Retrospective Study

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1675765 ◽

2018 ◽

Vol 14 (03) ◽

pp. 089-095

Author(s):

Cahide Bulut ◽

Hüseyin Çaksen ◽

Rahmi Örs ◽

Nuriye Tarakcı

Keyword(s):

Medical Records ◽

Brain Magnetic Resonance Imaging ◽

Common Symptom ◽

Cmv Infection ◽

Neurodevelopmental Outcomes ◽

Congenital Cytomegalovirus ◽

Congenital Cmv Infection ◽

Delays In Diagnosis ◽

Congenital Cmv

Background To evaluate clinical and neurodevelopmental outcomes and neuroimaging results of patients diagnosed with congenital cytomegalovirus (cCMV) infection and those diagnosed with possible congenital CMV (possible cCMV) infection. Methods From January 2014 to January 2016, 24 patients were diagnosed with congenital CMV infection. Clinical and neuroimaging results of these patients were examined from their medical records. Results Of the 24 patients, 6 were diagnosed with cCMV, whereas 18 patients were diagnosed with possible cCMV. Petechia was the most common symptom observed in patients with cCMV infection, whereas microcephaly was more common in patients with possible cCMV. Of the 24 patients, 5 (20.8%) showed normal neuroimaging characteristics. The most commonly encountered abnormal findings in brain magnetic resonance imaging were hypoplasia of corpus callosum (16.7%) and hydrocephalous (16.7%). All of the patients had poor neurodevelopmental outcomes. Conclusions Early diagnosis of asymptomatic cCMV infection is difficult. This study suggests that possible cCMV infections are more prevalent compared with cCMV infections, and delays in diagnosis occur due to not keeping suspicion of CMV infection in early phase. Clinicians should consider long-term neurodevelopmental sequelae of cCMV and possible cCMV infections and remember to screen congenital CMV infection in suspected individuals.

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Ganciclovir: Antiviral Therapy for Congenital Cytomegalovirus

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.28.1.41 ◽

2009 ◽

Vol 28 (1) ◽

pp. 41-46

Author(s):

Susan Givens Bell

Keyword(s):

Antiviral Therapy ◽

Blood Transfusions ◽

Cmv Infection ◽

Short Term ◽

Congenital Cytomegalovirus ◽

Congenital Cmv Infection ◽

Perinatally Infected ◽

Control And Prevention ◽

Congenital Cmv

CYTOMEGALOVIRUS (CMV), a member of the herpesvirus family, is the most common virus passed from the mother to the fetus. According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 150 children is born with congenital CMV infection.1 Neonates may also acquire CMV during delivery, via blood transfusions, or through breast milk. Both prenatally and perinatally infected infants are at risk for developing short-term effects and long-term sequelae and are candidates for antiviral therapy.2 Each year, approximately 8,000 children suffer permanent disabilities secondary to CMV infection.1

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Insight Into Long-term Neurodevelopmental Outcomes in Asymptomatic Congenital CMV Infection

PEDIATRICS ◽

10.1542/peds.2017-2526 ◽

2017 ◽

Vol 140 (5) ◽

pp. e20172526 ◽

Cited By ~ 6

Author(s):

Suresh B. Boppana ◽

Karen B. Fowler

Keyword(s):

Cmv Infection ◽

Neurodevelopmental Outcomes ◽

Congenital Cmv Infection ◽

Insight Into ◽

Congenital Cmv

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Cytomegalovirus

10.1093/med/9780190604813.003.0001 ◽

2018 ◽

Author(s):

Mark R. Schleiss

Keyword(s):

Low Birthweight ◽

Congenital Infection ◽

Future Research ◽

Cmv Infection ◽

Birth Prevalence ◽

Congenital Cmv Infection ◽

Different Populations ◽

Hearing Outcomes ◽

Congenital Cmv

Congenital infection with human cytomegalovirus (CMV) is the most common infectious cause of developmental disability in newborns. Congenital CMV is also a leading cause of hearing loss in infants. The overall birth prevalence of congenital CMV is 0.5–1%, varying among different populations. CMV infection may be symptomatic at birth or, more commonly, asymptomatic. Both groups are at risk for sequelae. Antiviral therapy with ganciclovir (or valganciclovir) in infants with symptomatic congenital CMV infection can result in improved neurodevelopmental and hearing outcomes. CMV infections in very low birthweight premature infants, typically acquired via breast milk, can also produce substantial short-term and possibility long-term morbidity. This chapter reviews current concepts regarding the biology of CMV as well as the epidemiology, clinical presentation, diagnosis, management, and outcome of congenital and perinatal CMV infections. High-priority areas for future research, including in the arena of newborn screening for congenital CMV, are discussed.

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